Provider Demographics
NPI:1114080850
Name:D'AMORE, DIANE ALLISON (MFT)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:ALLISON
Last Name:D'AMORE
Suffix:
Gender:F
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6924 HAWAIIAN SKY CT
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89131-1026
Mailing Address - Country:US
Mailing Address - Phone:702-838-0132
Mailing Address - Fax:702-435-4460
Practice Address - Street 1:7331 W CHARLESTON BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89117-1570
Practice Address - Country:US
Practice Address - Phone:702-838-0132
Practice Address - Fax:702-435-4460
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVMFT0806101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health