Individual
DR. DIANE KAY FELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD, LP
Contact information
Practice address
11165 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 531-0566
(763) 531-0602
Mailing address
11165 ZEALAND AVE N, CHAMPLIN, MN 55316-3595
(763) 531-0566
(763) 531-0602
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
LP1489
MN
103TC2200X
Clinical Child & Adolescent Psychologist
Primary
LP1489
MN
103TF0200X
Forensic Psychologist
LP1489
MN
103TH0004X
Health Psychologist
LP1489
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
104655
UCARE
MN
05
—
193852500
—
MN
01
—
4H026FE
BLUECROSSBLUESHIELD
MN
01
—
61-12600
MEDICA
MN
01
—
HP35175
HEALTHPARTNERS
MN
Enumeration date
11/13/2006
Last updated
02/13/2025
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