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Individual

MS. DIANE PISANO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW C

Contact information

Practice address
14300 GALLANT FOX LN, SUITE 107, BOWIE, MD 20715-4003
(301) 805-5124
(301) 805-1351
Mailing address
3715 IVY HILL LANE, BOWIE, MD 20715
(301) 805-5124
(301) 805-1351

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
O6414
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
146561900
MD
Enumeration date
11/27/2006
Last updated
09/18/2009
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