Provider Demographics
NPI:1902370505
Name:DIVERSE ASSESSMENTS AND TREATMENT, LLC
Entity Type:Organization
Organization Name:DIVERSE ASSESSMENTS AND TREATMENT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:SIGLER
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:651-481-0664
Mailing Address - Street 1:1935 CTY RD B2 W STE 270
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:651-481-0664
Mailing Address - Fax:612-392-0400
Practice Address - Street 1:1935 CTY RD B2 W STE 270
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113
Practice Address - Country:US
Practice Address - Phone:651-481-0664
Practice Address - Fax:612-392-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-16
Last Update Date:2019-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty