Diane Johnson Prosser, Phd., LLC

NPI #1508213844 in South Bend, Indiana

Provider Information

NPI Number: 1508213844
Entity Type: Organization
Organization Name: Diane Johnson Prosser, Phd., LLC
Primary Specialty: Psychologist - Clinical
Enumeration Date: May 17, 2016
Last Updated: May 17, 2016

Practice Location

Address: 227 N DIXIE WAY
Address 2: SUITE 110
City: South Bend
State: Indiana
ZIP Code: 46637-3385
Phone: (574) 850-8486

Authorized Official

Name: DIANE JOHNSON PROSSER, HSPP
Title: SOLE PROPRIETOR
Phone: (574) 850-8486

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist - Clinical — Clinical	103TC0700X	Primary

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