Provider Demographics
NPI:1518248293
Name:DIACO, JOANNA ELIZABETH (MS)
Entity Type:Individual
Prefix:
First Name:JOANNA
Middle Name:ELIZABETH
Last Name:DIACO
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:ELIZABETH
Other - Last Name:TRUSLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:12 HEWLETT ST
Mailing Address - Street 2:
Mailing Address - City:RYE
Mailing Address - State:NY
Mailing Address - Zip Code:10580-3223
Mailing Address - Country:US
Mailing Address - Phone:914-967-6100
Mailing Address - Fax:914-921-2796
Practice Address - Street 1:12 HEWLETT ST
Practice Address - Street 2:
Practice Address - City:RYE
Practice Address - State:NY
Practice Address - Zip Code:10580-3223
Practice Address - Country:US
Practice Address - Phone:914-967-6100
Practice Address - Fax:914-921-2796
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool