Provider Demographics
NPI:1841434552
Name:HELLER, DIANA G (MED)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:G
Last Name:HELLER
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 18TH ST
Mailing Address - Street 2:
Mailing Address - City:KEY WEST
Mailing Address - State:FL
Mailing Address - Zip Code:33040-4620
Mailing Address - Country:US
Mailing Address - Phone:305-292-6843
Mailing Address - Fax:
Practice Address - Street 1:1504 18TH ST
Practice Address - Street 2:
Practice Address - City:KEY WEST
Practice Address - State:FL
Practice Address - Zip Code:33040-4620
Practice Address - Country:US
Practice Address - Phone:305-292-6843
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-24
Last Update Date:2009-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health