Individual
MS. DIANA LYNN PHANEUF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6465
Mailing address
949 BRIDGEPORT AVE, MILFORD, CT 06460-3142
(203) 878-6365
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
0008889
CT
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
E32952
CT
Other
Enumeration date
03/21/2007
Last updated
09/06/2007
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