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General NPI Number Information
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NPI Number | 1811943103
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Entity Type | Individual
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Provider Name | DIANE LOUISE BRONG LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 02/18/2014
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Provider Practice Location Address
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Address Line | 1259 S CEDAR CREST BLVD SUITE 230
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City | ALLENTOWN
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State | PA
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Zip | 18103-6372
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Country | US
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Telephone | 610-402-5900
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Fax | 610-821-2038
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Provider Business Mailing Address
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Address Line | PO BOX 1754
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City | ALLENTOWN
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State | PA
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Zip | 18105-1754
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Country | US
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Telephone | 484-884-4500
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Fax | 484-884-0699
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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 | CW007406L
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License Number State | PA
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