Individual
DR. BRIAN VINCENT DIECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
13650 HIGHLAND ST, CEDAR LAKE, IN 46303-9800
(219) 677-2462
Mailing address
13650 HIGHLAND ST, CEDAR LAKE, IN 46303-9800
(219) 677-2462
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
20042237A
IN
Other
Enumeration date
03/09/2009
Last updated
03/09/2009
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