Individual
SARA JEAN DIESEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
921 W ELEVENTH ST, TRAVERSE CITY, MI 49684-3002
(810) 965-4425
Mailing address
309 W FRONT ST UNIT 301, TRAVERSE CITY, MI 49684-2751
(810) 965-4425
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
6352000979
MI
Other
Enumeration date
10/29/2025
Last updated
10/29/2025
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