# MRS. DIANE BUBECK

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1558540328
- **Gender:** F
- **Credential:** LMFT, RD, LDN, CLT

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 106H00000X | Marriage & Family Therapist | 166.000604 | IL | Yes |
| 133V00000X | Registered Dietitian | 1640011456 | IL | — |

## Other

- **Enumeration date:** 10/30/2007
- **Last updated:** 02/15/2017