Individual
DR. DIANE LOUISE ROTNEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD, LICSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
000535
CT
1041C0700X
Clinical Social Worker
19567
MN
1041C0700X
Clinical Social Worker
AP08-992
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
14000535CT 01
ANTHEM PROVIDER ID
CT
Enumeration date
05/17/2007
Last updated
08/27/2024
Update your record
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