Provider Demographics
NPI:1851520035
Name:AMSTUTZ, DIANNE L
Entity Type:Individual
Prefix:
First Name:DIANNE
Middle Name:L
Last Name:AMSTUTZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10845 HARNEY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68154-2639
Mailing Address - Country:US
Mailing Address - Phone:402-916-9421
Mailing Address - Fax:402-999-8221
Practice Address - Street 1:10845 HARNEY ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68154
Practice Address - Country:US
Practice Address - Phone:402-916-9421
Practice Address - Fax:402-999-8221
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2018-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health