Individual
MRS. DIANE JEAN WAACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
16831 TRAIL VIEW CIR, PARKER, CO 80134-4346
(303) 471-1769
Mailing address
16831 TRAIL VIEW CIR, PARKER, CO 80134-4346
(303) 471-1769
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
516
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
516
LCSW
CO
Enumeration date
12/30/2010
Last updated
12/30/2010
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