Provider Demographics
NPI:1396558151
Name:CHAMBERLAIN, DIAMOND N
Entity type:Individual
Prefix:
First Name:DIAMOND
Middle Name:N
Last Name:CHAMBERLAIN
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 1:8501 GLEN MICHAEL LN APT T2
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-5222
Mailing Address - Country:US
Mailing Address - Phone:443-909-8492
Mailing Address - Fax:
Practice Address - Street 1:8501 GLEN MICHAEL LN APT T2
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-5222
Practice Address - Country:US
Practice Address - Phone:443-909-8492
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-27
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior TechnicianGroup - Single Specialty