Individual
MRS. DIANE T. RYDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPA
Contact information
Practice address
1430 WILLOW LN, WEST PARK C61-2, NORTH WILKESBORO, NC 28659-3551
(336) 667-5151
(336) 667-5048
Mailing address
1400 WILLOW LN, WEST PARK C61-2, NORTH WILKESBORO, NC 28659-3551
(336) 667-5151
(336) 667-5048
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1958
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
135VN
BCBS OF NC
NC
05
—
6107297
—
NC
Enumeration date
03/23/2006
Last updated
08/22/2017
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