Individual
DR. DIANA RO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
4020 COPPER VW STE 104F, TRAVERSE CITY, MI 49684-7041
(231) 947-2255
Mailing address
4020 COPPER VW STE 104F, TRAVERSE CITY, MI 49684-7041
(231) 947-2255
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6301015909
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/26/2013
Last updated
07/11/2022
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