Individual
DIANE S MOONGROVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
8 HIGHWOOD ST, WATERVILLE, ME 04901-5740
(207) 861-3488
(207) 861-3470
Mailing address
8 HIGHWOOD ST, WATERVILLE, ME 04901-5740
(207) 861-3488
(207) 861-3470
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PS916
ME
Other
Enumeration date
10/25/2006
Last updated
07/08/2007
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