Provider Demographics
NPI:1841097243
Name:BAHLER, DIANE LITTLETON
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LITTLETON
Last Name:BAHLER
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:COOPERATIVE SCHOOL SERVICES
Mailing Address - Street 2:1389 SAINT GASPAR DRIVE
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-7361
Mailing Address - Country:US
Mailing Address - Phone:219-866-8540
Mailing Address - Fax:
Practice Address - Street 1:COOPERATIVE SCHOOL SERVICES
Practice Address - Street 2:1389 SAINT GASPAR DRIVE
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-7361
Practice Address - Country:US
Practice Address - Phone:219-866-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-25
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN1266147103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool