Doctor Name: | MRS. DIANE M MCMULLEN |
NPI Number: | 1548693468 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.C.S.W. |
License Number: | 075858 |
Business Practice Address: | 4511 Harlem Rd Suite 8 Snyder, NY - 142263803 |
Business Phone Number: | 7168392328 |
Business Fax Number: | |
Mailing Address: | 4511 Harlem Rd, Suite 8 SNYDER |
State: | NY |
Postal Code: | 142263803 |
Phone Number: | 7168392328 |
Fax Number: | |
NPI Enumeration Date: | 08/14/2013 |
NPI Last Update Date: | 08/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 075858 |
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 |