Organization
DIANE LATIMER, PSY.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DIANE LATIMER PSY.D. (PRESIDENT)
(336) 834-0145
Entity
Organization
Contact information
Practice address
3843 ATTUCKS DR., SUITE B, POWELL, OH 43065
(614) 553-7815
(336) 834-0149
Mailing address
3843 ATTUCKS DR., SUITE B, POWELL, OH 43065
(614) 553-7815
(336) 834-0149
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
2255
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0312L
BLUE CROSS BLUE SHIELD
NC
01
—
120080
VALUE OPTIONS
NC
05
—
6000011
—
NC
Enumeration date
03/20/2009
Last updated
09/19/2014
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