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General NPI Number Information
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NPI Number | 1689908733
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Entity Type | Individual
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Provider Name | DIANE RODE MPS, CCLS, LCAT
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Gender | Female
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Dates
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Enumeration Date | 09/22/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 1184 5TH AVE ROOM 350
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City | NEW YORK
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State | NY
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Zip | 10029-6503
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Country | US
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Telephone | 212-241-8024
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Fax | 212-427-3049
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Provider Business Mailing Address
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Address Line | 1 GUSTAVE L LEVY PL BOX 1153
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City | NEW YORK
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State | NY
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Zip | 10029-6574
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Country | US
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Telephone | 212-241-8024
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Fax | 212-427-3049
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 000048-1
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License Number State | NY
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