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General NPI Number Information
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NPI Number | 1740278340
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Entity Type | Individual
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Provider Name | DIANE M LA CORTE LCSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2005
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Last Update Date | 10/19/2011
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Provider Practice Location Address
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Address Line | 7501 WILES RD SUITE #102 B
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2063
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Country | US
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Telephone | 954-260-9948
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Fax |
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Provider Business Mailing Address
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Address Line | 8349 NW 51ST MNR
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City | CORAL SPRINGS
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State | FL
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Zip | 33067-2807
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Country | US
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Telephone | 954-260-9948
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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 | SW6907
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License Number State | FL
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