Individual
MS. DIANE MARIE MAGNUSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
112 MADGE LN, SANTA ROSA BEACH, FL 32459-3082
(850) 267-4615
Mailing address
112 MADGE LN, SANTA ROSA BEACH, FL 32459-3082
(850) 267-4615
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW 4862
FL
Other
Enumeration date
09/21/2006
Last updated
07/08/2007
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