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General NPI Number Information
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NPI Number | 1174704027
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Entity Type | Individual
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Provider Name | DIANE HUNTLEY LOAIS 101YM0800X
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Gender | Female
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 11/18/2019
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Provider Practice Location Address
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Address Line | 141 NORTH ST STE 3
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City | PITTSFIELD
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State | MA
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Zip | 01201-4121
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Country | US
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Telephone | 413-442-4003
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Fax |
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Provider Business Mailing Address
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Address Line | 64 TOWN CRIER DR APT 27
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City | BRATTLEBORO
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State | VT
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Zip | 05301-6851
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Country | US
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Telephone | 413-629-1253
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 6964
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License Number State | MA
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