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Individual

DIANE TODD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
57950 LEAVENWORTH ST, 22D MEDICAL GROUP, MCCONNELL AFB, KS 67221-3506
(316) 759-5091
(316) 759-1304
Mailing address
57950 LEAVENWORTH ST, 22D MEDICAL GROUP, MCCONNELL AFB, KS 67221-3506
(316) 759-5091
(316) 759-1304

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1139
KS

Other

Enumeration date
05/23/2006
Last updated
10/05/2010
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