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Individual

ABBEY J DIECKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CSAC

Contact information

Practice address
108 W 2ND ST N, LADYSMITH, WI 54848-1338
(715) 532-9771
Mailing address
406 TECHNOLOGY DR E STE B, MENOMONIE, WI 54751-2768
(715) 235-4696

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
15717-132
WI
101YA0400X
Addiction (Substance Use Disorder) Counselor
15735-131
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1427322759
DEANHEALTH PLAN
WI
05
1427322759
WI
01
MALOMABB
MERCYCARE INSURANCE
WI
Enumeration date
03/05/2012
Last updated
02/01/2021
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