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General NPI Number Information
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NPI Number | 1821531815
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Entity Type | Individual
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Provider Name | DIANE HUEBNER DILLON PHD
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Gender | Female
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 11/23/2016
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Provider Practice Location Address
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Address Line | 215 LONG POND RD
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City | GREAT BARRINGTON
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State | MA
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Zip | 01230-1169
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Country | US
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Telephone | 413-717-9554
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Fax |
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Provider Business Mailing Address
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Address Line | 215 LONG POND RD
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City | GREAT BARRINGTON
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State | MA
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Zip | 01230-1169
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Country | US
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Telephone | 413-717-9554
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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 | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 013206
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | 9142
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License Number State | MA
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