Provider Demographics
NPI:1114775293
Name:PAISLEY, DIANA J
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:J
Last Name:PAISLEY
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 1:615 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19363-1630
Mailing Address - Country:US
Mailing Address - Phone:610-401-1475
Mailing Address - Fax:
Practice Address - Street 1:320 KING OF PRUSSIA RD
Practice Address - Street 2:
Practice Address - City:RADNOR
Practice Address - State:PA
Practice Address - Zip Code:19087-4440
Practice Address - Country:US
Practice Address - Phone:610-527-9360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-13
Last Update Date:2024-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health