Individual
DIANE IHEBOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 W ALLEGHENY AVE, PHILADELPHIA, PA 19133-3644
(215) 291-2500
Mailing address
18 JOPPA RD, WORCESTER, MA 01602-2230
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
04/10/2025
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