Gretchen A Diem, PHD | |
700 Rayovac Drive, Suite 311, Madison, WI 53711-2476 | |
(608) 492-0053 | |
Not Available |
Full Name | Gretchen A Diem |
---|---|
Gender | Female |
Speciality | Clinical Psychologist |
Experience | 22 Years |
Location | 700 Rayovac Drive, Madison, Wisconsin |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972521946 | NPI | - | NPPES |
2591-57 | Other | WI | PSYCH |
PSY19404 | Other | CA | PSYCH |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
103T00000X | Psychologist | PSY19404 (California) | Secondary |
103T00000X | Psychologist | 2591-57 (Wisconsin) | Primary |
Entity Name | Madison Health Psychology Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1639759343 PECOS PAC ID: 8921416165 Enrollment ID: O20210428000272 |
Mailing Address | Practice Location Address |
---|---|
Gretchen A Diem, PHD 700 Rayovac Drive, Suite 311, Madison, WI 53711-2476 Ph: (608) 492-0053 | Gretchen A Diem, PHD 700 Rayovac Drive, Suite 311, Madison, WI 53711-2476 Ph: (608) 492-0053 |
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