Provider Demographics
NPI:1508177270
Name:HOLZINGER, DIANE ELLEN (DIANE HOLZINGER)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:ELLEN
Last Name:HOLZINGER
Suffix:
Gender:F
Credentials:DIANE HOLZINGER
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:HOLZINGER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DIANE HOLZINGER
Mailing Address - Street 1:135 OCEAN PKWY
Mailing Address - Street 2:APT.17R
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2567
Mailing Address - Country:US
Mailing Address - Phone:718-436-4716
Mailing Address - Fax:
Practice Address - Street 1:135 OCEAN PKWY
Practice Address - Street 2:APT.17R
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-2567
Practice Address - Country:US
Practice Address - Phone:718-436-4716
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-28
Last Update Date:2010-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR017986101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional