Individual
DIANE L CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
115 MAIN ST STE 2D, NORTH EASTON, MA 02356-1469
(508) 238-7766
(508) 230-5089
Mailing address
115 MAIN ST STE 2D, NORTH EASTON, MA 02356-1469
(508) 238-7766
(508) 230-5089
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
100478
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
761754
TUFTS HEALTH PLAN
MA
01
—
PO1190
MASS BC BS ID
MA
Enumeration date
06/16/2006
Last updated
10/18/2010
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