Wakefield, Diane Rose

Wakefield, Diane Rose is an sole proprietor health care provider with primary practice located at 6113 Pheasant Ridge Dr , Port Orange FL 32128-6988. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Behavior Technician, Agencies / Early Intervention Provider Agency. Agencies / Early Intervention Provider Agency is her primary health care specialty. Wakefield, Diane Rose can be contacted via phone (386) 334-0183.

Contact Information

Primary practice address
6113 Pheasant Ridge Dr Port Orange FL 32128-6988
Phone: (386) 334-0183
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Behavior Technician 106S00000X
Agencies / Early Intervention Provider Agency 252Y00000X Florida

Profile Details

NPI number 1225541063
LBN Legal business name Wakefield, Diane Rose
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 15th, 2017
Last updated Jan 27th, 2019 - about 6 years 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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