Provider Demographics
NPI:1770695900
Name:PRESCOTT, DIANA L (PHD)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:PRESCOTT
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Gender:F
Credentials:PHD
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Mailing Address - Street 1:108 B MAIN ROAD SOUTH
Mailing Address - Street 2:HAMPDEN PSYCHOLOGICAL CONSULTATION, PLLC
Mailing Address - City:HAMPDEN
Mailing Address - State:ME
Mailing Address - Zip Code:04444
Mailing Address - Country:US
Mailing Address - Phone:207-862-3370
Mailing Address - Fax:207-862-3350
Practice Address - Street 1:108 B MAIN ROAD SOUTH
Practice Address - Street 2:HAMPDEN PSYCHOLOGICAL CONSULTATION, PLLC
Practice Address - City:HAMPDEN
Practice Address - State:ME
Practice Address - Zip Code:04444
Practice Address - Country:US
Practice Address - Phone:207-862-3370
Practice Address - Fax:207-862-3350
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MEPS838103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical