Provider Demographics
NPI:1588008106
Name:SCHUBERT, DIANA MARIE (LMT)
Entity Type:Individual
Prefix:MISS
First Name:DIANA
Middle Name:MARIE
Last Name:SCHUBERT
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:713 E 13TH ST
Mailing Address - Street 2:SUITE B UPSTAIRS
Mailing Address - City:WHITEFISH
Mailing Address - State:MT
Mailing Address - Zip Code:59937-2982
Mailing Address - Country:US
Mailing Address - Phone:406-671-1443
Mailing Address - Fax:
Practice Address - Street 1:713 E 13TH ST
Practice Address - Street 2:SUITE B UPSTAIRS
Practice Address - City:WHITEFISH
Practice Address - State:MT
Practice Address - Zip Code:59937-2982
Practice Address - Country:US
Practice Address - Phone:406-671-1443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT412225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist