Individual
DIANE ERICA BASNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
55 DORSET XING UNIT 535, SIMSBURY, CT 06070-1479
(601) 608-8884
Mailing address
55 DORSET XING UNIT 535, SIMSBURY, CT 06070-1479
(601) 608-8884
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
219541
MA
Other
Enumeration date
03/08/2018
Last updated
03/08/2018
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