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General NPI Number Information
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NPI Number | 1649480419
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Entity Type | Individual
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Provider Name | DIANE THERESA ZEIDWIG L.M.F.T.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 324 E CHURCH ST
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City | DELAND
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State | FL
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Zip | 32724-4309
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Country | US
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Telephone | 386-736-4722
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Fax | 386-736-4717
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Provider Business Mailing Address
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Address Line | 713 SWAYING PINE WAY
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City | DELAND
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State | FL
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Zip | 32724-8057
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Country | US
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Telephone | 386-736-3798
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Fax | 386-736-4717
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 102L00000X
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Taxonomy Name | Psychoanalyst
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License Number | MT1376
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MT1376
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License Number State | FL
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