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1801963061
DIANE DISTASO
MANCHESTER, NH
NPI
1801963061
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2006-11-30
Last Update Date
2007-07-08
Business Address
-- DIANE DISTASO MED, CCBT
401 CYPRESS ST
MANCHESTER, NH 03103-3628
Phone number: 603-668-4111
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Mailing Address
-- DIANE DISTASO MED, CCBT
401 CYPRESS ST
MANCHESTER, NH 03103-3628
Phone number: 603-668-4111
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