Provider Demographics
NPI:1205010683
Name:FARELLA, DIANE HUBEL (MA, CEIS)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:HUBEL
Last Name:FARELLA
Suffix:
Gender:F
Credentials:MA, CEIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 COLUMBUS AVENUE EXT
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-4903
Mailing Address - Country:US
Mailing Address - Phone:413-443-6125
Mailing Address - Fax:
Practice Address - Street 1:388 COLUMBUS AVENUE EXT
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-4903
Practice Address - Country:US
Practice Address - Phone:413-443-6125
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist