Healthcare Provider Details

I. General information

NPI: 1558291385
Provider Name (Legal Business Name): DIANA MARIA TEEL PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2026
Last Update Date: 05/22/2026
Certification Date: 05/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

590 MAIN ST
SANDOWN NH
03873-2109
US

IV. Provider business mailing address

590 MAIN ST
SANDOWN NH
03873-2109
US

V. Phone/Fax

Practice location:
  • Phone: 603-489-7061
  • Fax:
Mailing address:
  • Phone: 603-489-7061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TP0016X
TaxonomyPrescribing (Medical) Psychologist
License Number044629-23
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: