Individual
MRS. DIANE SMITH BRISSEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSWC
Contact information
Practice address
124 N MAIN ST, BERLIN, MD 21811-1060
(410) 641-4598
Mailing address
124 N MAIN ST, P.O. BOX 925, BERLIN, MD 21811-1060
(410) 641-4598
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
08289
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
222731200
—
MD
Enumeration date
09/01/2006
Last updated
06/10/2010
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