Provider Demographics
NPI:1437124955
Name:BYTHELL, DIANE LEE (PHD)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:LEE
Last Name:BYTHELL
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 1:1112 IOWA ST
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66044-1920
Mailing Address - Country:US
Mailing Address - Phone:785-841-9911
Mailing Address - Fax:
Practice Address - Street 1:1112 IOWA ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-1920
Practice Address - Country:US
Practice Address - Phone:785-841-9911
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS590103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS013320Medicare ID - Type Unspecified