Individual
DIANA LIGHTFOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2200 LAKE AVE, SUITE 225, FORT WAYNE, IN 46805-5397
(260) 726-9348
(260) 726-9340
Mailing address
240 N TILLOTSON AVE, MUNCIE, IN 47304-3988
(765) 288-1928
(765) 741-0310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
34007781A
IN
Other
Enumeration date
08/12/2015
Last updated
03/27/2017
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