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Organization

CHANGESU

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DIANA SAUM HERRING LMHC (OWNER)
(727) 422-5659
Entity
Organization

Contact information

Practice address
998 EMERSON DRIVE, DUNEDIN, FL 34698
(727) 422-5659
(727) 279-4944
Mailing address
998 EMERSON DR, DUNEDIN, FL 34698-6039
(727) 422-5659
(727) 279-4944

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
IMH1215
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1043587959
FL
Enumeration date
09/27/2017
Last updated
07/21/2022
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