Provider Demographics
NPI:1366719908
Name:DIAMOND, STEPHANIE E (PHD)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:E
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 NE 40TH ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33137-3502
Mailing Address - Country:US
Mailing Address - Phone:305-505-7605
Mailing Address - Fax:305-505-7605
Practice Address - Street 1:35 NE 40TH ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33137-3502
Practice Address - Country:US
Practice Address - Phone:305-505-7605
Practice Address - Fax:305-505-7605
Is Sole Proprietor?:No
Enumeration Date:2011-11-28
Last Update Date:2016-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist