Provider Demographics
NPI:1124353347
Name:HABEGGER, DIANE JUNE (OTR)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:JUNE
Last Name:HABEGGER
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:JUNE
Other - Last Name:AHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR
Mailing Address - Street 1:710 NORTH AVE
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49017-3258
Mailing Address - Country:US
Mailing Address - Phone:269-788-3040
Mailing Address - Fax:269-788-3043
Practice Address - Street 1:710 NORTH AVE
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3258
Practice Address - Country:US
Practice Address - Phone:269-788-3040
Practice Address - Fax:269-788-3043
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5201003053225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist