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General NPI Number Information
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NPI Number | 1245460146
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Entity Type | Individual
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Provider Name | DIANE E PASEOS MSW, LICSW
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Gender | Female
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Dates
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Enumeration Date | 07/26/2009
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Last Update Date | 04/13/2012
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Provider Practice Location Address
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Address Line | 153 HAZARD AVE
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City | ENFIELD
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State | CT
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Zip | 06082-4592
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Country | US
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Telephone | 860-253-5020
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Fax | 860-253-5030
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Provider Business Mailing Address
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Address Line | PO BOX 935
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City | EAST LONGMEADOW
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State | MA
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Zip | 01028-0935
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 114447
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 005515
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License Number State | CT
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