Organization
MICHELLE DIEHL, PSY.D., R.N., PL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE-ANNE DIEHL PSYD, RN (SOLE MEMBER/OWNER/PROVIDER)
(813) 957-2765
Entity
Organization
Contact information
Practice address
209 LITHIA PINECREST RD, BRANDON, FL 33511-5307
(813) 957-2765
Mailing address
209 LITHIA PINECREST RD, BRANDON, FL 33511-5307
(813) 957-2765
(813) 657-1049
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
8005
FL
Other
Enumeration date
12/01/2009
Last updated
06/04/2020
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