Doctor Name: | LEEANN DIEDRICK |
NPI Number: | 1063451599 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 073395-1 |
Business Practice Address: | 950 S Oyster Bay Rd Hicksville, NY - 118013510 |
Business Phone Number: | 5168226111 |
Business Fax Number: | 5163422496 |
Mailing Address: | 950 S Oyster Bay Rd, HICKSVILLE |
State: | NY |
Postal Code: | 118013510 |
Phone Number: | 5168226111 |
Fax Number: | 5163422496 |
NPI Enumeration Date: | 06/06/2006 |
NPI Last Update Date: | 05/03/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 073395-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |