Provider Demographics
NPI:1891004776
Name:SAUNDERS, DIANA L
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:SAUNDERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DIANA
Other - Middle Name:L
Other - Last Name:SAUNDERS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA, LPC
Mailing Address - Street 1:16 MOUNTAIN VIEW AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3420
Mailing Address - Country:US
Mailing Address - Phone:303-485-7200
Mailing Address - Fax:720-257-5497
Practice Address - Street 1:16 MOUNTAIN VIEW AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3420
Practice Address - Country:US
Practice Address - Phone:303-485-7200
Practice Address - Fax:720-257-5497
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-27
Last Update Date:2010-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO5723101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional