Individual
DIANE MARIE VANKEVICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1160 DICKINSON ST, SPRINGFIELD, MA 01108-3122
(413) 455-1740
Mailing address
123 BUCKINGHAM ST, SPRINGFIELD, MA 01109-3926
(413) 262-1264
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
04/11/2018
Last updated
04/11/2018
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