Provider Demographics
NPI:1659484137
Name:STRICKLAND, DIANA V (LMT)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:V
Last Name:STRICKLAND
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:PO BOX 124
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32326-0124
Mailing Address - Country:US
Mailing Address - Phone:850-926-6789
Mailing Address - Fax:850-926-6789
Practice Address - Street 1:94 COTTONWOOD ST
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-2142
Practice Address - Country:US
Practice Address - Phone:850-926-6789
Practice Address - Fax:850-926-6789
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2009-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMA42632225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL20-4953404OtherEIN