Provider Demographics
NPI:1821148891
Name:LEMIEUX, DIANNE JEANNINE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANNE
Middle Name:JEANNINE
Last Name:LEMIEUX
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 1:1220 CRAIG RD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8240
Mailing Address - Country:US
Mailing Address - Phone:865-558-3011
Mailing Address - Fax:865-558-3012
Practice Address - Street 1:1512 COLEMAN RD
Practice Address - Street 2:SUITE 301
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37909-2828
Practice Address - Country:US
Practice Address - Phone:865-558-3011
Practice Address - Fax:865-558-3012
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNP0000001026103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3682324Medicare ID - Type Unspecified