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Individual

MS. DIANE ALAINE COHEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
144 AMHERST AVE, WALTHAM, MA 02451-3170
(617) 852-1097
Mailing address
144 AMHERST AVE, WALTHAM, MA 02451-3170
(617) 852-1097

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110954
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
(CO)PO7274
BLUE CROSS BLUE SHIELD
MA
05
1891944
MA
01
412798
MAGELLAN
MA
01
501887
VALUE OPTIONS
MA
Enumeration date
05/23/2007
Last updated
11/29/2022
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