Provider Demographics
NPI:1346571510
Name:CERUTTI, DIANA (MA)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:CERUTTI
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 DAMON RD
Mailing Address - Street 2:APT 6303
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-1864
Mailing Address - Country:US
Mailing Address - Phone:413-584-3623
Mailing Address - Fax:
Practice Address - Street 1:39 UNION ST
Practice Address - Street 2:
Practice Address - City:EASTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01027-1468
Practice Address - Country:US
Practice Address - Phone:413-529-1764
Practice Address - Fax:413-529-9047
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health