Provider Demographics
NPI:1346775541
Name:KLEMAN, DIANA
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:KLEMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5330 HEATHERDOWNS BLVD
Mailing Address - Street 2:100
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-4657
Mailing Address - Country:US
Mailing Address - Phone:330-837-3555
Mailing Address - Fax:419-861-3720
Practice Address - Street 1:5330 HEATHERDOWNS BLVD
Practice Address - Street 2:100
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43614-4657
Practice Address - Country:US
Practice Address - Phone:330-837-3555
Practice Address - Fax:419-861-3720
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1.0007039-SUPV1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical