Individual
LISA JOAN DIEFENBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 463-3262
Mailing address
793 OLD ROUTE 119 HWY N, INDIANA, PA 15701-1372
(724) 465-5576
(724) 463-3262
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PS015877
PA
Other
Enumeration date
07/19/2006
Last updated
07/09/2007
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