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General NPI Number Information
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NPI Number | 1770862526
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Entity Type | Individual
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Provider Name | DIANNE M HERIVEL LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/11/2011
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Last Update Date | 03/15/2017
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Provider Practice Location Address
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Address Line | 16825 48TH AVE W STE 408
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City | LYNNWOOD
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State | WA
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Zip | 98037-6405
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Country | US
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Telephone | 206-713-4884
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Fax | 425-774-6328
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Provider Business Mailing Address
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Address Line | 4509 181ST PL SW
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City | LYNNWOOD
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State | WA
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Zip | 98037-4620
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Country | US
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Telephone | 206-713-4884
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Fax | 425-774-6328
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LF60143446
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License Number State | WA
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