Provider Demographics
NPI:1962528950
Name:VILLALOBOS, DIANA MARIA (AMFTI - ASSOCIATE MA)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARIA
Last Name:VILLALOBOS
Suffix:
Gender:F
Credentials:AMFTI - ASSOCIATE MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1250 CENTRAL AVE
Mailing Address - Street 2:S1
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:323-253-0836
Mailing Address - Fax:
Practice Address - Street 1:220 EASTMONT AVE CHILDRENS HOME SOCIETY OF WASHINGTON
Practice Address - Street 2:SUITE B
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-885-9090
Practice Address - Fax:509-884-0118
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA68791101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health