Individual
DIANE YVONNE DEGRAFFENREID
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1500 WASHINGTON AVE, EVANSVILLE, IN 47714-2059
(812) 475-1390
(812) 475-1398
Mailing address
PO BOX 3276, EVANSVILLE, IN 47731-3276
(812) 473-0181
(812) 492-6498
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34004695A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
22000000373645
ANTHEM PIN
IN
01
—
34004695A
LCSW STATE LICENSE
IN
Enumeration date
01/16/2007
Last updated
06/06/2023
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