Provider Demographics
NPI:1598569071
Name:DIAMOND, MIKAYLA (CERT DEEP TRAUMA)
Entity type:Individual
Prefix:MS
First Name:MIKAYLA
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:
Credentials:CERT DEEP TRAUMA
Other - Prefix:DR
Other - First Name:MIKAYLA
Other - Middle Name:
Other - Last Name:DIAMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:17417 RED OAK DR APT 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-1281
Mailing Address - Country:US
Mailing Address - Phone:213-407-3419
Mailing Address - Fax:213-407-3419
Practice Address - Street 1:17417 RED OAK DR APT 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-1281
Practice Address - Country:US
Practice Address - Phone:213-407-3419
Practice Address - Fax:213-407-3419
Is Sole Proprietor?:No
Enumeration Date:2025-04-03
Last Update Date:2025-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach