Provider Demographics
NPI:1083837165
Name:FREIHEIT, DIANE S (MS)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:S
Last Name:FREIHEIT
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 HOWARD ST STE 305
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:VT
Mailing Address - Zip Code:05401-5986
Mailing Address - Country:US
Mailing Address - Phone:802-357-2948
Mailing Address - Fax:
Practice Address - Street 1:156 COLLEGE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:BURLINGTON
Practice Address - State:VT
Practice Address - Zip Code:05401-8423
Practice Address - Country:US
Practice Address - Phone:802-651-7679
Practice Address - Fax:802-860-0183
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0000568103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT18809OtherBCBSVT PROVIDER NUMBER