Provider Demographics
NPI:1003897588
Name:MILLER, DIANE MW (LPC)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MW
Last Name:MILLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DIANE
Other - Middle Name:M
Other - Last Name:WACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:632 CUMBERLAND ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17042-5230
Mailing Address - Country:US
Mailing Address - Phone:717-273-1710
Mailing Address - Fax:717-273-1416
Practice Address - Street 1:334 YORK ST
Practice Address - Street 2:
Practice Address - City:GETTYSBURG
Practice Address - State:PA
Practice Address - Zip Code:17325-1930
Practice Address - Country:US
Practice Address - Phone:717-337-0026
Practice Address - Fax:717-337-1260
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC003686101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional