MEDICARE: MS. DIANNE BASKIN LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	16895	TX

General Provider Information

NPI Number	:	1417228297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DIANNE BASKIN LPC

Provider Business Mailing Address
First Line	:	3411 COOPER BR E
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-7909
Country	:	US
Telephone Number	:	972-839-9805
Fax Number	:

Provider Business Practice Location Address
First Line	:	608 N BELL AVE
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76209-4206
Country	:	US
Telephone Number	:	972-839-9805
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/25/2012
Last Update Date	:	01/25/2012

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