Provider Demographics
NPI:1013081645
Name:LORANGER, DIANE (PE)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:LORANGER
Suffix:
Gender:F
Credentials:PE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 331
Mailing Address - Street 2:
Mailing Address - City:SACO
Mailing Address - State:ME
Mailing Address - Zip Code:04072-0331
Mailing Address - Country:US
Mailing Address - Phone:207-423-2543
Mailing Address - Fax:
Practice Address - Street 1:6 WELLSPRING RD
Practice Address - Street 2:SUITE 4
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9415
Practice Address - Country:US
Practice Address - Phone:207-423-2543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2008-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPE721103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical