Healthcare Provider Details

I. General information

NPI: 1952407959
Provider Name (Legal Business Name): DIANA LYNN SKLAR I LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 WASHINGTON ST SUITE 160
NORWOOD MA
02062-3441
US

IV. Provider business mailing address

3 COUNTRYSIDE LN
NORWOOD MA
02062-1701
US

V. Phone/Fax

Practice location:
  • Phone: 781-762-4799
  • Fax: 781-769-5356
Mailing address:
  • Phone: 781-762-4799
  • Fax: 781-769-5356

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number1020310
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: