Provider Demographics
NPI:1821531815
Name:DILLON, DIANE HUEBNER (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:HUEBNER
Last Name:DILLON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 LONG POND RD
Mailing Address - Street 2:
Mailing Address - City:GREAT BARRINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01230-1169
Mailing Address - Country:US
Mailing Address - Phone:413-717-9554
Mailing Address - Fax:
Practice Address - Street 1:215 LONG POND RD
Practice Address - Street 2:
Practice Address - City:GREAT BARRINGTON
Practice Address - State:MA
Practice Address - Zip Code:01230-1169
Practice Address - Country:US
Practice Address - Phone:413-717-9554
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-23
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013206103T00000X
MA9142103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist