Provider Demographics
NPI:1245443977
Name:SCAGLIOTTI, DIANE MAUREEN (MA LCMHC)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:MAUREEN
Last Name:SCAGLIOTTI
Suffix:
Gender:F
Credentials:MA LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1045 ELM ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03101
Mailing Address - Country:US
Mailing Address - Phone:603-491-7987
Mailing Address - Fax:603-622-0498
Practice Address - Street 1:1045 ELM ST
Practice Address - Street 2:SUITE 202
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03101
Practice Address - Country:US
Practice Address - Phone:603-491-7987
Practice Address - Fax:603-622-0498
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH358101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30421428Medicaid
NH61006OtherCOUNTY 2110AS