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Individual
DIANNA GRACE MASTO
Active
Individual
DIANNA GRACE MASTO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R028591-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000411397001
BLUE SHIELD OF NENY PRO #
NY
01
—
546490
VALUEOPTIONS PIN
NY
01
—
7350232
GHI PIN
NY
Enumeration date
12/21/2006
Last updated
03/20/2024
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