Individual
MRS. DIANNE DAHLBOM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
4 MUZZEY ST, LEXINGTON, MA 02421-5220
(339) 927-6769
Mailing address
302 BISHOPS FOREST DR, WALTHAM, MA 02452-8809
(781) 893-3028
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1029403
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P07722
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/29/2006
Last updated
07/08/2007
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