Provider Demographics
NPI:1679807937
Name:NEUMAN, DIANE C (MA, LMFT)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:C
Last Name:NEUMAN
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 BEACH DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE EGG HARBOR TWP
Mailing Address - State:NJ
Mailing Address - Zip Code:08087-1002
Mailing Address - Country:US
Mailing Address - Phone:609-709-9955
Mailing Address - Fax:
Practice Address - Street 1:125 E MAIN ST
Practice Address - Street 2:SUITE 6
Practice Address - City:TUCKERTON
Practice Address - State:NJ
Practice Address - Zip Code:08087-2669
Practice Address - Country:US
Practice Address - Phone:609-709-9955
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-18
Last Update Date:2014-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37FI00160700106H00000X
PAMF000160106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMF000160OtherPENNSYLVANIA MARRIAGE AND FAMILY THERAPY LICENSE
NJ37FI00160700OtherNEW JERSEY MARRIAGE AND FAMILY LICENSE