Provider Demographics
NPI:1003099896
Name:GOTTLIEB, DIANNE (MS LMFT)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:GOTTLIEB
Suffix:
Gender:F
Credentials:MS LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8115 E INDIAN BEND RD STE 119
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85250-4819
Mailing Address - Country:US
Mailing Address - Phone:480-314-0055
Mailing Address - Fax:844-364-0345
Practice Address - Street 1:8115 E INDIAN BEND RD STE 119
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85250-4819
Practice Address - Country:US
Practice Address - Phone:480-314-0055
Practice Address - Fax:844-364-0345
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-14
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZLMFT10236106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist