Individual
HEATHER MARIE DIYENNO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
53 BAXTER BLVD, PORTLAND, ME 04101-1827
(603) 883-0005
(603) 883-0007
Mailing address
40 KENILWORTH ST, PORTLAND, ME 04102-2018
(207) 807-3229
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LC8013
ME
Other
Enumeration date
06/19/2023
Last updated
06/19/2023
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