Provider Demographics
NPI:1659055622
Name:HAMMOND, DIANA MARIE (LMT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:HAMMOND
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 1:4700 RICHMOND RD STE 100
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-5985
Mailing Address - Country:US
Mailing Address - Phone:216-378-9390
Mailing Address - Fax:
Practice Address - Street 1:4700 RICHMOND RD STE 100
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44128-5985
Practice Address - Country:US
Practice Address - Phone:216-378-9390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH33.026457225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist