Individual
AMY DIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LAC
Contact information
Practice address
10301 MAYO DR, BARLING, AR 72923-1660
(479) 494-5760
(479) 484-8142
Mailing address
4253 N CROSSOVER RD, FAYETTEVILLE, AR 72703-4593
(479) 521-5731
(479) 521-6520
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
A0210072
AR
Other
Enumeration date
07/01/2006
Last updated
07/08/2007
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