Individual
DR. DIANE LISA BAILEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LPC, CRC
Contact information
Practice address
2209 QUARRY DR, SUITE C36, WEST LAWN, PA 19609-1155
(610) 441-3378
Mailing address
3644 MOUNTAIN RD, HAMBURG, PA 19526-7939
(610) 441-3378
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
PC004216
PA
101YP2500X
Professional Counselor
3880
NC
225C00000X
Rehabilitation Counselor
12561
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6105074
—
NC
Enumeration date
07/10/2006
Last updated
03/04/2008
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