| Doctor Name: | DIANNE LYNN MACKELLAR |
| NPI Number: | 1083745418 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LMHC LMFT CADAC |
| License Number: | 1978 |
| Business Practice Address: | 34 Bayes Hill Rd Oak Bluffs, MA - 02557 |
| Business Phone Number: | 5086937996 |
| Business Fax Number: | |
| Mailing Address: | Box 2287, VINEYARD HAVEN |
| State: | MA |
| Postal Code: | 02568 |
| Phone Number: | 5086935890 |
| Fax Number: | |
| NPI Enumeration Date: | 03/08/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 1978 |
| Healthcare Provider Taxonomy: (Secondary) | X |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |