Individual
DIANE WACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
100 S PINE ISLAND RD, STE 230, PLANTATION, FL 33324-2613
(954) 370-2140
(954) 916-1252
Mailing address
8710 LAKE DASHA TER, PLANTATION, FL 33324-3121
(954) 562-0451
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW6975
FL
Other
Enumeration date
07/27/2006
Last updated
07/09/2007
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