Individual
DR. INGRID MARY DIEDEREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PH D
Contact information
Practice address
172 ASHELAND AVENUE, SUITE D, ASHEVILLE, NC 28801
(828) 253-1445
(828) 253-1456
Mailing address
172 ASHELAND AVENUE, SUITE D, ASHEVILLE, NC 28801
(828) 253-1445
(828) 253-1456
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1376
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0324H
BCBS
—
Enumeration date
12/04/2006
Last updated
07/08/2007
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