Individual
MS. DIANA PADRUTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Mailing address
474 N YELLOW SPRINGS ST, SPRINGFIELD, OH 45504-2463
(937) 399-9500
(937) 342-4242
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LICDC.912921
OH
1041C0700X
Clinical Social Worker
Primary
I.0009305-SUPV
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000375355
ANTHEM
OH
Enumeration date
10/31/2005
Last updated
12/14/2017
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