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General NPI Number Information
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NPI Number | 1871012211
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Entity Type | Individual
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Provider Name | DIANE GARVES
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Gender | Female
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Dates
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Enumeration Date | 09/18/2017
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 901 DOMINION DR STE A
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City | HUDSON
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State | WI
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Zip | 54016-9333
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Country | US
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Telephone | 717-808-8070
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Fax |
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Provider Business Mailing Address
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Address Line | 1695 99TH AVE
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City | HAMMOND
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State | WI
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Zip | 54015-5067
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Country | US
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Telephone | 715-781-6397
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 7740-120
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3212-125
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License Number State | WI
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