Individual
MS. DIANA I BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
349 E NORTHFIELD RD, LIVINGSTON, NJ 07039-4802
(973) 350-4824
Mailing address
41 BROOKDALE GDNS APT A, BLOOMFIELD, NJ 07003-6365
(973) 350-4824
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05832500
NJ
1041C0700X
Clinical Social Worker
44SL06180000
NJ
Other
Enumeration date
12/05/2018
Last updated
01/06/2019
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