Provider Demographics
NPI:1972831659
Name:HATTLER, DIANE YVONNE (LPC)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:YVONNE
Last Name:HATTLER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10043 NOKESVILLE RD
Mailing Address - Street 2:HOUSE OF MERCY
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-4131
Mailing Address - Country:US
Mailing Address - Phone:703-659-1636
Mailing Address - Fax:703-659-0081
Practice Address - Street 1:10043 NOKESVILLE RD
Practice Address - Street 2:HOUSE OF MERCY
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4131
Practice Address - Country:US
Practice Address - Phone:703-659-1636
Practice Address - Fax:703-659-0081
Is Sole Proprietor?:No
Enumeration Date:2009-11-18
Last Update Date:2009-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004292101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health