Provider Demographics
NPI:1801038930
Name:REIFF, DIANNE (OTR)
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:REIFF
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 S 4TH ST.
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76701
Mailing Address - Country:US
Mailing Address - Phone:254-297-7089
Mailing Address - Fax:254-296-2932
Practice Address - Street 1:324 S 4TH ST
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76701-2227
Practice Address - Country:US
Practice Address - Phone:254-297-7089
Practice Address - Fax:254-296-2932
Is Sole Proprietor?:No
Enumeration Date:2009-04-06
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112821225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist