Individual
DIANE MCDERMOTT KLEIST
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0920
NH
225100000X
Physical Therapist
PT379
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0806164Y0NH02
ANTHEM BC/BS
NH
01
—
2198450
FIRST HEALTH NETWORK
NH
05
—
30392870
—
NH
01
—
3533245
AETNA
NH
01
—
5515310
CCN
NH
Enumeration date
08/10/2006
Last updated
07/09/2007
Update your record
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