Provider Demographics
NPI:1861520355
Name:DIONNE, L. HELENE (PHD)
Entity type:Individual
Prefix:
First Name:L.
Middle Name:HELENE
Last Name:DIONNE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 SHORE RD
Mailing Address - Street 2:
Mailing Address - City:GLOUCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01930-3916
Mailing Address - Country:US
Mailing Address - Phone:978-525-3506
Mailing Address - Fax:978-525-3023
Practice Address - Street 1:31 SHORE RD
Practice Address - Street 2:
Practice Address - City:GLOUCESTER
Practice Address - State:MA
Practice Address - Zip Code:01930-3916
Practice Address - Country:US
Practice Address - Phone:978-525-3506
Practice Address - Fax:978-525-3023
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA635943103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA004405OtherHARVARD PILGRIM