Doctor Name: | ERIC LEWIS DIAMOND |
NPI Number: | 1144578014 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.S.W., L.C.S.W. |
License Number: | 7817-123 |
Business Practice Address: | 7821 N Fairchild Rd Fox Point, WI - 532173116 |
Business Phone Number: | 4063963028 |
Business Fax Number: | |
Mailing Address: | 7821 N Fairchild Rd, FOX POINT |
State: | WI |
Postal Code: | 532173116 |
Phone Number: | 4063963028 |
Fax Number: | |
NPI Enumeration Date: | 08/26/2012 |
NPI Last Update Date: | 08/26/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 7817-123 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |