Individual
MS. DIANE LYNN LASICHAK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW, LCSW-C, CMC
Contact information
Practice address
20459 OLD GREY PL, ASHBURN, VA 20147-5522
(571) 333-2889
Mailing address
19309 WINMEADE DR, SUITE #334, LANSDOWNE, VA 20176-6507
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904004583
VA
1041C0700X
Clinical Social Worker
10153
MD
Other
Enumeration date
04/25/2014
Last updated
04/25/2014
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