Individual
DIANA MICHELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
600 JOHNSON AVE STE C5, BOHEMIA, NY 11716-2669
(631) 533-0315
Mailing address
600 JOHNSON AVE STE C5, BOHEMIA, NY 11716-2669
(631) 533-0315
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
007639
NY
Other
Enumeration date
02/09/2019
Last updated
02/09/2019
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