Individual
MRS. CHRISTINA R DIESEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
231 N MAIN ST, BREESE, IL 62230-1522
(618) 322-6424
(618) 227-8227
Mailing address
231 N MAIN ST, BREESE, IL 62230-1522
(618) 322-6424
(618) 227-8227
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-010456
IL
Other
Enumeration date
04/09/2007
Last updated
03/14/2019
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