Dietra Duffala Teichmann in Peoria - Clinical Neuropsychologist
Dietra Duffala Teichmann - NPI 1831181726
Dietra Duffala Teichmann is a Clinical Neuropsychologist in Peoria, Illinois. Dietra Duffala Teichmann practices all healthcare services and medical treatments related to Clinical Neuropsychologist. The NPI Number for Dietra Duffala Teichmann is 1831181726. The last update date is 2007-07-08.
Dietra Duffala Teichmann's current location address is 5401 N Knoxville Ave, Peoria, Illinois. You can contact this provider via phone number 3092821864 and fax number 3092821867. The mailing address for Dietra Duffala Teichmann is 5401 N Knoxville Ave, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Dietra Duffala Teichmann |
|---|---|
| Address | 5401 N Knoxville Ave, Peoria, Illinois |
| Phone Number | 3092821864 |
| Fax Number | 3092821867 |
| Sole Proprietor | X |
| Credentials | PH.D. |
NPI Number Detail
| NPI Number | 1831181726 |
|---|---|
| Provider Enumeration Date | 2005-08-17 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 5401 N Knoxville Ave |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616145098 |
| Phone Number | 3092821864 |
| Fax Number | 3092821867 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical Neuropsychologist |
|---|---|
| Taxonomy | 103G00000X |
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Definition: A clinical psychologist who applies principles of assessment and intervention based upon the scientific study of human behavior as it relates to normal and abnormal functioning of the central nervous system. The specialty is dedicated to enhancing th |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7272021 | IL | BLUE CROSS/BLUE SHIELD |
Post Comment/ Review Below
What is the Dietra Duffala Teichmann's unique identification number?
The Dietra Duffala Teichmann has been assigned the NPI (National Provider Identifier) Number 1831181726 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete physical address where Dietra Duffala Teichmann is located?
The Dietra Duffala Teichmann is situated at the following address: 5401 N Knoxville Ave, Peoria, IL, 616145098.
What is Dietra Duffala Teichmann's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Dietra Duffala Teichmann's specialized field of practice is Clinical Neuropsychologist, and the corresponding taxonomy code that categorizes this area of specialization is 103G00000X.
On what date did the Dietra Duffala Teichmann receive its 1831181726 assignment from the Centers for Medicare & Medicaid Services?
The Dietra Duffala Teichmann was assigned its 1831181726 by the Centers for Medicare & Medicaid Services on 2005-08-17.
When was the information regarding Dietra Duffala Teichmann, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Dietra Duffala Teichmann, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2007-07-08.