DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. DIANE CASANUEVA ELLIOTT, PHD

Active Sole Proprietor

DR. DIANE CASANUEVA ELLIOTT, PHD is a Child, Clinical Psychologist healthcare provider located in MACON, Georgia. NPI 1083768402 is currently active in the NPPES registry. Verify at CMS.

Child, Clinical Psychologist · MACON, GA

Registration Details

NPI Number
1083768402
Provider Type
Individual
Gender
Female
NPI Issued
Jan 23, 2007 (19.585911668532 yrs)
Last Updated
Jun 13, 2014
Licenses
PST000800 (GA)
PSY003112 (GA)
Sole Proprietor
Yes

Practice Information

Address
277 PIERCE AVE
MACON, GA, 312042419
Browse GA providers · Browse ZIP 31204
Phone
4787550060
Fax
4787433508
Primary Specialty
Child, Clinical Psychologist
103TC2200X
Additional Specialty
Child, Clinical Psychologist

Other Child, Clinical Psychologist Providers in MACON, GA

Name Credential NPI
DR. JAMES D. WARREN PHD 1316060601
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.