Provider Demographics
NPI:1982798104
Name:RABER, DIANE MARIE (PT)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MARIE
Last Name:RABER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 W 81ST PL
Mailing Address - Street 2:#100
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80031-4380
Mailing Address - Country:US
Mailing Address - Phone:303-650-6616
Mailing Address - Fax:303-650-0718
Practice Address - Street 1:5005 W 81ST PL
Practice Address - Street 2:#100
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80031-4380
Practice Address - Country:US
Practice Address - Phone:303-650-6616
Practice Address - Fax:303-650-0718
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1190225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO376618Medicare ID - Type Unspecified