Heribacka, Diane Judith

Heribacka, Diane Judith is an individual health care provider with primary practice located at 6700 S Washington Ave , Titusville FL 32780-8050. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Marriage & Family Therapist, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Heribacka, Diane Judith can be contacted via phone (321) 722-5200.

Contact Information

Primary practice address
6700 S Washington Ave Titusville FL 32780-8050
Phone: (321) 722-5200
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 35001728A Indiana
Behavioral Health & Social Service Providers / Mental Health 101YM0800X MT3289 Florida

Profile Details

NPI number 1700169752
LBN Legal business name Heribacka, Diane Judith
Credentials LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 26th, 2011
Last updated May 14th, 2024 - about 6 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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