Doctor Name: | DIANE LOUISE FARRELL |
NPI Number: | 1457412868 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | |
Business Practice Address: | 2960 Chartres St La Salle, IL - 613011097 |
Business Phone Number: | 8152230160 |
Business Fax Number: | 8152231634 |
Mailing Address: | Po Box 1488, 2960 Chartres St. LA SALLE |
State: | IL |
Postal Code: | 613013488 |
Phone Number: | 8152230160 |
Fax Number: | 8152231634 |
NPI Enumeration Date: | 12/12/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |