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Individual
DIANE JUDITH HERIBACKA
Active
Individual
DIANE JUDITH HERIBACKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMFT
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MT3289
FL
106H00000X
Marriage & Family Therapist
35001728A
IN
Other
Enumeration date
09/26/2011
Last updated
05/14/2024
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