Healthcare Provider Details

I. General information

NPI: 1649110503
Provider Name (Legal Business Name): DIANA AZARYAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DIANA AZARYAN-MINAMI

II. Dates (important events)

Enumeration Date: 03/31/2026
Last Update Date: 03/31/2026
Certification Date: 03/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1336 E MAIN ST
COLUMBUS OH
43205-2081
US

IV. Provider business mailing address

1775 FRANKLIN PARK S
COLUMBUS OH
43205-2217
US

V. Phone/Fax

Practice location:
  • Phone: 614-534-0951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberC.2406265-TRNE
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: