Provider Demographics
NPI:1073330734
Name:SHAY, DIANA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SHAY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MILES AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-3049
Mailing Address - Country:US
Mailing Address - Phone:406-598-4973
Mailing Address - Fax:
Practice Address - Street 1:1320 DIVISION ST
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6001
Practice Address - Country:US
Practice Address - Phone:406-409-4541
Practice Address - Fax:406-869-7764
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-24
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT72751101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty