Individual
KARLA L DIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
3 WALCOTT ST, SOUTH PARIS, ME 04281
(207) 330-1834
Mailing address
PO BOX 2074, AUBURN, ME 04211-2074
(207) 330-1834
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS1355
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0030363
MEDICARE PTAN
ME
05
—
1295956480
—
ME
Enumeration date
05/02/2007
Last updated
04/18/2019
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