Provider Demographics
NPI:1184842247
Name:ZECKHAUSEN, DIANA MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:MARIE
Last Name:ZECKHAUSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1827 POWERS FERRY RD SE
Mailing Address - Street 2:BUILDING 22, STE 200
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30339-5621
Mailing Address - Country:US
Mailing Address - Phone:770-953-4744
Mailing Address - Fax:770-953-4640
Practice Address - Street 1:1827 POWERS FERRY RD SE
Practice Address - Street 2:BUILDING 22, STE 200
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5621
Practice Address - Country:US
Practice Address - Phone:770-953-4744
Practice Address - Fax:770-953-4640
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA1482103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist