Doctor Name: | DIANE GALE BLIVEN |
NPI Number: | 1013011279 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M. ED. |
License Number: | 18437 |
Business Practice Address: | 500 Mason St Tomball, TX - 773754450 |
Business Phone Number: | 2812559922 |
Business Fax Number: | 2812559064 |
Mailing Address: | 13226 N Decker Dr, MAGNOLIA |
State: | TX |
Postal Code: | 773553826 |
Phone Number: | 2814151528 |
Fax Number: | |
NPI Enumeration Date: | 09/11/2006 |
NPI Last Update Date: | 03/19/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 18437 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |