Provider Demographics
NPI:1407624463
Name:DIODATO, HEATHER M
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:M
Last Name:DIODATO
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 1:60751 PLACE RD
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MI
Mailing Address - Zip Code:48048-1786
Mailing Address - Country:US
Mailing Address - Phone:586-770-8473
Mailing Address - Fax:
Practice Address - Street 1:60751 PLACE RD
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48048-1786
Practice Address - Country:US
Practice Address - Phone:586-770-8473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care