Individual
MRS. DIANA RATANAKICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
702 MOUNT AUBURN ST, WATERTOWN, MA 02472-1522
(617) 972-9400
Mailing address
705 MOUNT AUBURN ST, WATERTOWN, MA 02472-1508
(617) 972-9400
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
115161
MA
Other
Enumeration date
07/19/2018
Last updated
07/19/2018
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