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Individual

MS. DIANA MARIE CLINE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCSW -706 LCSW

Contact information

Practice address
425 W LOUCKS ST, SHERIDAN, WY 82801-4128
(307) 751-7916
Mailing address
PO BOX 7282, SHERIDAN, WY 82801-7005
(307) 751-7916

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCSW 706
WY
101YM0800X
Mental Health Counselor
LCSW 706
WY
1041C0700X
Clinical Social Worker
Primary
LCSW 706
WY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1225003023
WY
05
1932229523
WY
Enumeration date
04/22/2009
Last updated
03/08/2022
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