Individual
MS. WANDA SUE DIEKHANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC
Contact information
Practice address
1108 FRANKLIN, FORT BENTON, MT 59442
(406) 788-6574
(406) 727-3791
Mailing address
PO BOX 905, FORT BENTON, MT 59442
(406) 788-6574
(406) 727-3799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
LCPC 994
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
254473
—
MT
01
—
745473
BCBS
MT
Enumeration date
12/08/2006
Last updated
07/08/2007
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