Provider Demographics
NPI:1861709297
Name:DIAKONOVA-CURTIS, DARIA
Entity type:Individual
Prefix:DR
First Name:DARIA
Middle Name:
Last Name:DIAKONOVA-CURTIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE # S51
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195-2867
Mailing Address - Country:US
Mailing Address - Phone:216-695-0419
Mailing Address - Fax:216-445-4378
Practice Address - Street 1:9500 EUCLID AVE # S51
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44195-2867
Practice Address - Country:US
Practice Address - Phone:216-695-0419
Practice Address - Fax:216-445-4378
Is Sole Proprietor?:No
Enumeration Date:2010-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.08451103TC0700X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical