Provider Demographics
NPI:1700074812
Name:DEPALMA, DIANE MARIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:MARIE
Last Name:DEPALMA
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 PENNSYLVANIA AVE NW
Mailing Address - Street 2:SUITE 602
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20006-3405
Mailing Address - Country:US
Mailing Address - Phone:703-629-1925
Mailing Address - Fax:
Practice Address - Street 1:1901 PENNSYLVANIA AVE NW
Practice Address - Street 2:SUITE 602
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20006-3405
Practice Address - Country:US
Practice Address - Phone:703-629-1925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-15
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPSY 1098103TC0700X
VA0810003810103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical