Provider Demographics
NPI:1386798262
Name:GAGLIANO, DIANE M (MA, LPC)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:GAGLIANO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2530 WOLF PACK RUN
Mailing Address - Street 2:
Mailing Address - City:HELLERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18055-3359
Mailing Address - Country:US
Mailing Address - Phone:908-310-6694
Mailing Address - Fax:
Practice Address - Street 1:2530 WOLF PACK RUN
Practice Address - Street 2:
Practice Address - City:HELLERTOWN
Practice Address - State:PA
Practice Address - Zip Code:18055-3359
Practice Address - Country:US
Practice Address - Phone:908-310-6694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00283100101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional