Basic Information
| Provider Information | |||||||||
| NPI: | 1215176417 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELLER | ||||||||
| FirstName: | DIANE | ||||||||
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| Credential: | OTR | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4050 AIRPORT CENTER DR | ||||||||
| Address2: | SUITE D | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922641216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603255950 | ||||||||
| FaxNumber: | 7603255945 | ||||||||
| Practice Location | |||||||||
| Address1: | 4050 AIRPORT CENTER DR | ||||||||
| Address2: | SUITE D | ||||||||
| City: | PALM SPRINGS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 922641216 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7603255950 | ||||||||
| FaxNumber: | 7603255945 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/11/2009 | ||||||||
| LastUpdateDate: | 02/11/2009 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | OT1044 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.