Organization
DIANE COLONNELLO,LCSW,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DIANE COLONNELLO LCSW (PRESIDENT)
(239) 275-9665
Entity
Organization
Contact information
Practice address
8192 COLLEGE PKWY, STE. 50, FORT MYERS, FL 33919-5175
(239) 275-9665
(239) 267-4438
Mailing address
8192 COLLEGE PKWY, STE. 50, FORT MYERS, FL 33919-5175
(239) 275-9665
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
SW1700
FL
Other
Enumeration date
10/22/2010
Last updated
10/22/2010
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