Individual
DIANA PRIMOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SOCIAL WORKER
Contact information
Practice address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(762) 408-4018
Mailing address
6600 VAN AALST BLVD BLDG 9250, FORT MOORE, GA 31905-2102
(762) 408-4018
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
9460
SC
Other
Enumeration date
08/09/2022
Last updated
01/15/2025
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