Provider Demographics
NPI:1205847837
Name:HOOVER, DIANE P (PH D)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:P
Last Name:HOOVER
Suffix:
Gender:F
Credentials:PH D
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 206
Mailing Address - Street 2:
Mailing Address - City:CORNWALL
Mailing Address - State:PA
Mailing Address - Zip Code:17016-0206
Mailing Address - Country:US
Mailing Address - Phone:717-272-6621
Mailing Address - Fax:
Practice Address - Street 1:1700 SOUTH LINCOLN AVE (690)
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17042
Practice Address - Country:US
Practice Address - Phone:717-272-6621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS007484L103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical