Individual
DIANE ELISE KOLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
599 CANAL ST, LAWRENCE, MA 01840-1244
(978) 453-5736
Mailing address
599 CANAL ST, LAWRENCE, MA 01840-1244
(978) 453-5736
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
116369
MA
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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