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Individual

DIANA TAYLOR LIVI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW C

Contact information

Practice address
6525 NORTH CHARLES STREET, SUITE 136 THE GIBSON BUILDING, TOWSON, MD 21204-6872
(443) 838-6075
(410) 869-0720
Mailing address
401 OAK CT, CATONSVILLE, MD 21228-5842
(410) 869-0720
(410) 869-0720

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
6171
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
QQ39DT
CAREFIRST BC AND BS
MD
Enumeration date
08/29/2006
Last updated
09/30/2010
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