Provider Demographics
NPI:1962578492
Name:HIEBELER, DIANA L H (MA, OTR)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:L H
Last Name:HIEBELER
Suffix:
Gender:F
Credentials:MA, OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11501 JOHNSON RD
Mailing Address - Street 2:
Mailing Address - City:LEANDER
Mailing Address - State:TX
Mailing Address - Zip Code:78641-5823
Mailing Address - Country:US
Mailing Address - Phone:512-267-5852
Mailing Address - Fax:
Practice Address - Street 1:12501 HYMEADOW DR
Practice Address - Street 2:BLDG. 1, SUITE F
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2263
Practice Address - Country:US
Practice Address - Phone:512-331-5488
Practice Address - Fax:512-331-5489
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100677225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics