| Diane Latimer, Psy.d., P.c. | |
|
3843 Attucks Dr. Suite B Powell OH 43065 | |
| (614) 553-7815 | |
| (336) 834-0149 |
| Full Name | Diane Latimer, Psy.d., P.c. |
|---|---|
| Speciality | Psychologist |
| Location | 3843 Attucks Dr., Powell, Ohio |
| Authorized Official Name and Position | Diane Latimer (PRESIDENT) |
| Authorized Official Contact | 3368340145 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Diane Latimer, Psy.d., P.c. 3843 Attucks Dr. Suite B Powell OH 43065 Ph: (614) 553-7815 | Diane Latimer, Psy.d., P.c. 3843 Attucks Dr. Suite B Powell OH 43065 Ph: (614) 553-7815 |
| NPI Number | 1891936852 |
|---|---|
| Provider Enumeration Date | 03/20/2009 |
| Last Update Date | 09/19/2014 |
| Medicare PECOS PAC ID | 6800110123 |
|---|---|
| Medicare Enrollment ID | O20150115000489 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891936852 | NPI | - | NPPES |
| 120080 | Other | NC | VALUE OPTIONS |
| 0312L | Other | NC | BLUE CROSS BLUE SHIELD |
| 6000011 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 2255 (North Carolina) | Primary |
| Provider Name | Diane E Latimer |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1114954674 PECOS PAC ID: 3375637689 Enrollment ID: I20150115000662 |
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