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General NPI Number Information
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NPI Number | 1619198561
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Entity Type | Individual
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Provider Name | DIANE S SYLVIA LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 02/14/2017
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Provider Practice Location Address
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Address Line | 222 NEW RD STE 405
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City | LINWOOD
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State | NJ
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Zip | 08221
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Country | US
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Telephone | 609-234-4670
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Fax | 609-788-0515
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Provider Business Mailing Address
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Address Line | 110 E WILMONT AVE
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City | SOMERS POINT
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State | NJ
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Zip | 08244
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Country | US
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Telephone | 609-234-4670
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Fax | 609-788-0515
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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 | 44SC04609500
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License Number State | NJ
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