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Individual

MS. DIANE JOHNSON BODDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
1401 HOLLIDAY ST STE 218, WICHITA FALLS, TX 76301-7143
(940) 322-3434
(940) 322-0505
Mailing address
1401 HOLLIDAY ST STE 218, WICHITA FALLS, TX 76301-7143
(940) 322-3434
(940) 322-0505

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
15172
TX

Other

Enumeration date
11/16/2006
Last updated
07/08/2007
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