Provider Demographics
NPI:1043587959
Name:HERRING, DIANA SAUM (MS)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:SAUM
Last Name:HERRING
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:HERRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:998 EMERSON DR
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34698-6039
Mailing Address - Country:US
Mailing Address - Phone:727-422-5659
Mailing Address - Fax:727-734-8813
Practice Address - Street 1:3251 3RD AVE N. SUITE 125
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33713
Practice Address - Country:US
Practice Address - Phone:727-321-3854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-20
Last Update Date:2018-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH1268101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health