| Doctor Name: | DR. DIANNE MARINO SUROVCIK |
| NPI Number: | 1982668570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | PSOOP188L |
| Business Practice Address: | 800 Main St Suite 106 Hellertown, PA - 180551535 |
| Business Phone Number: | 4848513486 |
| Business Fax Number: | 4848513358 |
| Mailing Address: | 800 Main St, Suite 106 HELLERTOWN |
| State: | PA |
| Postal Code: | 180551535 |
| Phone Number: | 4848513486 |
| Fax Number: | 4848513358 |
| NPI Enumeration Date: | 04/12/2006 |
| NPI Last Update Date: | 03/15/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 103TC1900X |
| License Number: | PSOOP188L |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Psychologist |
| Taxonomy Specialization: | Counseling |
| Taxonomy Definition: | |