Provider Demographics
NPI:1871694968
Name:HERBERT, DIANE R (PSYD)
Entity type:Individual
Prefix:DR
First Name:DIANE
Middle Name:R
Last Name:HERBERT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4240 HUNT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-6612
Mailing Address - Country:US
Mailing Address - Phone:513-891-0650
Mailing Address - Fax:513-891-2838
Practice Address - Street 1:4240 HUNT RD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-6612
Practice Address - Country:US
Practice Address - Phone:513-891-0650
Practice Address - Fax:513-891-2838
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6073103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist