Individual
MS. DIANNE H. DISSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LP
Contact information
Practice address
967 ROUTE 22, BREWSTER, NY 10509-1526
(845) 494-6789
Mailing address
16 LACONA DR, PATTERSON, NY 12563-2023
(845) 494-6789
Taxonomy
Speciality
Code
Description
License number
State
102L00000X
Psychoanalyst
Primary
19 000868
NY
Other
Enumeration date
06/13/2011
Last updated
06/13/2011
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