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Individual

MS. DIANA KWIECINSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
1040 KINGS HWY N, SUITE 100, CHERRY HILL, NJ 08034-1908
(856) 414-1155
Mailing address
PO BOX 1074, MEDFORD, NJ 08055-6074
(908) 881-4368

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC01304000
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
44SC01304000
LIC CLINICAL SOCIAL WORKE
NJ
Enumeration date
05/09/2007
Last updated
07/08/2007
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