Provider Demographics
NPI:1902358948
Name:WARREN, DIANA MARIE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:WARREN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:MARIE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT, DPT
Mailing Address - Street 1:16052 FOSTER ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66085-8876
Mailing Address - Country:US
Mailing Address - Phone:913-897-8960
Mailing Address - Fax:
Practice Address - Street 1:16052 FOSTER ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66085-8876
Practice Address - Country:US
Practice Address - Phone:913-897-8960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-25
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016038203225100000X
KS1105456225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist