| Doctor Name: | DIANE LOUISE LONDON |
| NPI Number: | 1154300374 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MSMFT |
| License Number: | 3135-125 |
| Business Practice Address: | 219 Ross Ave Suite 101 Schofield, WI - 544766109 |
| Business Phone Number: | 7153554999 |
| Business Fax Number: | 7153555999 |
| Mailing Address: | 219 Ross Ave, Suite 101 SCHOFIELD |
| State: | WI |
| Postal Code: | 544766109 |
| Phone Number: | 7153554999 |
| Fax Number: | 7153555999 |
| NPI Enumeration Date: | 01/16/2006 |
| NPI Last Update Date: | 04/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 3135-125 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |