Individual
MS. DIANE L STAIB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
UPHAM'S ELDER SERVICE PLAN, 1140 DORCHESTER AVE, DORCHESTER, MA 02125
(617) 288-0970
(617) 474-0757
Mailing address
35 SWALLOW ST # 3, SOUTH BOSTON, MA 02127-3212
(617) 288-0970
(617) 474-0757
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
212349
MA
Other
Enumeration date
10/31/2006
Last updated
07/08/2007
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