Provider Demographics
NPI:1326415308
Name:DIBONA, ALANNAH (LMHC)
Entity Type:Individual
Prefix:
First Name:ALANNAH
Middle Name:
Last Name:DIBONA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 POND LN
Mailing Address - Street 2:SUITE 3A1
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9 POND LN
Practice Address - Street 2:SUITE 3A1
Practice Address - City:CONCORD
Practice Address - State:MA
Practice Address - Zip Code:01742-2858
Practice Address - Country:US
Practice Address - Phone:781-264-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-26
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9065101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor