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Individual

MRS. DIANA LEE MARIANI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
2200 FORT JESSE RD, NORMAL, IL 61761-6286
(309) 452-9001
(309) 452-9299
Mailing address
PO BOX 604, BLOOMINGTON, IL 61702-0604
(309) 663-7220
(309) 452-9299

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149.008157
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
05732025
BCBS
IL
Enumeration date
09/20/2006
Last updated
07/08/2007
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