Provider Demographics
NPI:1407279342
Name:PALMER-HELLER, DIANE (CPM, LM)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:PALMER-HELLER
Suffix:
Gender:F
Credentials:CPM, LM
Other - Prefix:MS
Other - First Name:DHYANA
Other - Middle Name:
Other - Last Name:HELLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPM, LM
Mailing Address - Street 1:214 HUSTON AVE
Mailing Address - Street 2:
Mailing Address - City:STROUDSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:18360-2331
Mailing Address - Country:US
Mailing Address - Phone:570-269-0238
Mailing Address - Fax:570-369-4966
Practice Address - Street 1:214 HUSTON AVE
Practice Address - Street 2:
Practice Address - City:STROUDSBURG
Practice Address - State:PA
Practice Address - Zip Code:18360-2331
Practice Address - Country:US
Practice Address - Phone:570-269-0238
Practice Address - Fax:570-369-4966
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-29
Last Update Date:2015-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA96120004176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife