Provider Demographics
NPI:1952321887
Name:DE CARDENAS, DIANA A (PSYCHOTHERAPIST)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:A
Last Name:DE CARDENAS
Suffix:
Gender:F
Credentials:PSYCHOTHERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8223 SW 82ND PL
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33143-6684
Mailing Address - Country:US
Mailing Address - Phone:305-596-9741
Mailing Address - Fax:
Practice Address - Street 1:8036 SW 81ST DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33143-6609
Practice Address - Country:US
Practice Address - Phone:305-270-7968
Practice Address - Fax:305-270-2540
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1236101Y00000X
FLMH 1926101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health