Individual
MRS. DIANE JAMIESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CADAC
Contact information
Practice address
29 PINE ST, SOUTHBRIDGE, MA 01550-1823
(508) 765-9167
(508) 764-2462
Mailing address
29 PINE ST, SOUTHBRIDGE, MA 01550-1823
(508) 765-9167
(508) 764-2462
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
0358
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1200704
—
MA
01
—
2222001910
BCBS
MA
Enumeration date
08/23/2006
Last updated
10/07/2008
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