Provider Demographics
NPI:1518943976
Name:KRIEL, DIANA THERESA (OT)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:THERESA
Last Name:KRIEL
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:373 DRIFTWOOD TER
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8258
Mailing Address - Country:US
Mailing Address - Phone:561-361-9851
Mailing Address - Fax:
Practice Address - Street 1:3066 JOG RD
Practice Address - Street 2:ADVANCED PEDIATRIC SYSTEM
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33467-2053
Practice Address - Country:US
Practice Address - Phone:561-357-5883
Practice Address - Fax:561-357-5884
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLOT10800225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics