Individual
DIANE GIANCASPRO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LMSW
Contact information
Practice address
819 W MICHIGAN ST, NEW BUFFALO, MI 49117-1252
(269) 405-3644
Mailing address
819 W MICHIGAN ST, NEW BUFFALO, MI 49117-1252
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
6801105817
MI
1041C0700X
Clinical Social Worker
34008695A
IN
1041C0700X
Clinical Social Worker
6801105817
MI
Other
Enumeration date
01/19/2020
Last updated
07/21/2022
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