Individual
DIANE SUE BIDWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LSCSW
Contact information
Practice address
22ND MEDICAL GROUP, 57950 LEAVENWORTH, MCCONNELL AFB, KS 67221-3506
(316) 759-2069
Mailing address
22ND MEDICAL GROUP, 57950 LEAVENWORTH, MCCONNELL AFB, KS 67221-3506
(316) 759-2069
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
3594
KS
Other
Enumeration date
07/19/2006
Last updated
01/04/2023
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