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Individual

MS. DIANA WYDO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCSW

Contact information

Practice address
4112 BLUE RIDGE ROAD, 2ND FLOOR, RALEIGH, NC 27612-4652
(919) 573-6520
(919) 573-6557
Mailing address
25 BLACKSTONE VALLEY PLACE, SUITE 300 FELLOWSHIP HEALTH RESOURCES INC, LINCOLN, RI 02865-1163
(401) 333-3980
(401) 333-3984

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C005621
NC

Other

Enumeration date
02/27/2008
Last updated
02/27/2008
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