Individual
KIM DIELMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
4206 PRINCE ST, CONWAY, AR 72034-9398
(501) 932-2055
(501) 932-2058
Mailing address
4206 PRINCE ST, CONWAY, AR 72034-9398
(501) 932-2055
(501) 932-2058
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
07-27P
AR
103T00000X
Psychologist
07-27P
AR
103TC0700X
Clinical Psychologist
Primary
07-27P
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194027719
—
AR
Enumeration date
05/04/2007
Last updated
06/10/2019
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