Provider Demographics
NPI:1033306196
Name:DIAN, ELAINE N (PCC)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:N
Last Name:DIAN
Suffix:
Gender:F
Credentials:PCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 518
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44677-0518
Mailing Address - Country:US
Mailing Address - Phone:330-202-3870
Mailing Address - Fax:330-202-3879
Practice Address - Street 1:2803 AKRON RD
Practice Address - Street 2:
Practice Address - City:WOOSTER
Practice Address - State:OH
Practice Address - Zip Code:44691-7904
Practice Address - Country:US
Practice Address - Phone:330-264-3232
Practice Address - Fax:330-202-3879
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE0002939101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional