Provider Demographics
NPI:1568685329
Name:MCGUFFIN, DIANE (PSYD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:
Last Name:MCGUFFIN
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:AMERY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PSYD
Mailing Address - Street 1:1701 AUGUSTINE CUT OFF
Mailing Address - Street 2:SUITE 8
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19803-4415
Mailing Address - Country:US
Mailing Address - Phone:302-588-8304
Mailing Address - Fax:
Practice Address - Street 1:1701 AUGUSTINE CUT OFF
Practice Address - Street 2:SUITE 8
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19803-4415
Practice Address - Country:US
Practice Address - Phone:302-588-5304
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2009-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEB10000602103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical