Individual
JEANETTE MARIE DIEKMAN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
484 WILLIAMSON RD, SUITE 105/E, MOORESVILLE, NC 28117-9110
(704) 500-1208
Mailing address
PO BOX 3993, MOORESVILLE, NC 28117-3993
(704) 500-1208
(704) 696-0434
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
3447
NC
Other
Enumeration date
12/05/2005
Last updated
07/08/2007
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