Provider Demographics
NPI:1134671332
Name:MUELLER, DIANE M (SCHOOL PSYCHOLOGIST)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:M
Last Name:MUELLER
Suffix:
Gender:F
Credentials:SCHOOL PSYCHOLOGIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36762 274TH STREET
Mailing Address - Street 2:
Mailing Address - City:PLATTE
Mailing Address - State:SD
Mailing Address - Zip Code:57369
Mailing Address - Country:US
Mailing Address - Phone:605-337-3006
Mailing Address - Fax:
Practice Address - Street 1:36762 274TH STREET
Practice Address - Street 2:
Practice Address - City:PLATTE
Practice Address - State:SD
Practice Address - Zip Code:57369
Practice Address - Country:US
Practice Address - Phone:605-337-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-04
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD51957-S103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool