Individual
DIANE A MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1306 N 13TH ST, NORFOLK, NE 68701-2591
(402) 371-8218
(402) 371-8259
Mailing address
PO BOX 53, NORFOLK, NE 68702-0053
(402) 371-8218
(402) 371-8259
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1650 LMPH 835 CMSW
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47080527026
—
NE
01
—
7702
MIDLANDS CHOICE
NE
01
—
83010
BC/BS
NE
Enumeration date
10/27/2006
Last updated
07/08/2007
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