Provider Demographics
NPI:1326110412
Name:AYOTTE, DIANA S (LCPC)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:S
Last Name:AYOTTE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2527 ROMANZA RD
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-6584
Mailing Address - Country:US
Mailing Address - Phone:435-237-1519
Mailing Address - Fax:
Practice Address - Street 1:2527 ROMANZA RD
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-6584
Practice Address - Country:US
Practice Address - Phone:435-237-1519
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-14
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT52034006004101YM0800X
NVCP3357-R101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health