Doctor Name: | DIANE APOSTOLOFF |
NPI Number: | 1104290253 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 424 Perry St La Porte, IN - 463503200 |
Business Phone Number: | 2198090333 |
Business Fax Number: | 2195310859 |
Mailing Address: | 424 Perry St, LA PORTE |
State: | IN |
Postal Code: | 463503200 |
Phone Number: | 2198090333 |
Fax Number: | 2195310859 |
NPI Enumeration Date: | 11/29/2015 |
NPI Last Update Date: | 11/29/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |