Provider Demographics
NPI:1932591914
Name:PATTI DIFFEE, M.A. LLC
Entity type:Organization
Organization Name:PATTI DIFFEE, M.A. LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PATTI
Authorized Official - Middle Name:J
Authorized Official - Last Name:DIFFEE
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:719-433-9636
Mailing Address - Street 1:5585 ERINDALE DR STE 201
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-6969
Mailing Address - Country:US
Mailing Address - Phone:719-433-9636
Mailing Address - Fax:
Practice Address - Street 1:5585 ERINDALE DR STE 201
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-6969
Practice Address - Country:US
Practice Address - Phone:719-433-9636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-26
Last Update Date:2015-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CONLC 0013225251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health