Provider Demographics
NPI:1619766367
Name:DITULIO, AVA
Entity type:Individual
Prefix:
First Name:AVA
Middle Name:
Last Name:DITULIO
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 1:58 ISLAND POND RD STE 1
Mailing Address - Street 2:
Mailing Address - City:ATKINSON
Mailing Address - State:NH
Mailing Address - Zip Code:03811-2000
Mailing Address - Country:US
Mailing Address - Phone:603-362-4444
Mailing Address - Fax:
Practice Address - Street 1:112B LOWELL RD
Practice Address - Street 2:
Practice Address - City:WINDHAM
Practice Address - State:NH
Practice Address - Zip Code:03087-1860
Practice Address - Country:US
Practice Address - Phone:603-845-1552
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool