Provider Demographics
NPI:1952047235
Name:KAZER, DIANE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:KAZER
Suffix:
Gender:F
Credentials:
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 4671
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86340-4671
Mailing Address - Country:US
Mailing Address - Phone:310-955-6565
Mailing Address - Fax:
Practice Address - Street 1:2335 BUCKBOARD RD
Practice Address - Street 2:
Practice Address - City:SEDONA
Practice Address - State:AZ
Practice Address - Zip Code:86336-3268
Practice Address - Country:US
Practice Address - Phone:310-955-6565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-09
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171400000XOther Service ProvidersHealth & Wellness CoachGroup - Single Specialty