Individual
DIANA KYRISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
5911 E NANCE ST, MESA, AZ 85215-1485
(919) 824-9832
Mailing address
5911 E NANCE ST, MESA, AZ 85215-1485
(919) 824-9832
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LCSW 12033
AZ
Other
Enumeration date
12/19/2006
Last updated
07/08/2007
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