Individual
DIANE SIEGMUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
112 N ABINGTON RD, CLARKS GREEN, PA 18411-2538
(570) 268-4077
Mailing address
112 N ABINGTON RD, CLARKS GREEN, PA 18411-2538
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS-006303-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
728645
BLUE SHIELD
PA
Enumeration date
01/23/2006
Last updated
07/08/2007
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