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General NPI Number Information
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NPI Number | 1710998547
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Entity Type | Individual
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Provider Name | DIANE JAGIELSKI LISW
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Gender | Female
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Dates
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Enumeration Date | 08/10/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 10000 BRECKSVILLE RD
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City | BRECKSVILLE
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State | OH
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Zip | 44141-3204
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Country | US
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Telephone | 440-526-3030
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Fax | 440-838-6085
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Provider Business Mailing Address
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Address Line | 7008 KAZIMIER AVE
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City | CLEVELAND
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State | OH
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Zip | 44105-5659
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Country | US
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Telephone | 216-441-1338
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Fax | 216-441-1338
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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 | I9076
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License Number State | OH
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