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Individual

MS. DIANNA LYNN AIDEUIS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW, MSW, RN, BSN

Contact information

Practice address
500 DEXTER ST STE C, GREENVILLE, NC 27834-6318
(252) 355-3900
(252) 355-3995
Mailing address
122 S HARVEY ST, WASHINGTON, NC 27889-5033
(252) 946-1091

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C004724
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
138FC
BCBS PROVIDER NUMBER
NC
05
6002853
NC
Enumeration date
11/01/2006
Last updated
07/09/2007
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