Individual
CARLIE LANE DIDIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
445 OAK ST, COPIAGUE, NY 11726-3111
(631) 257-5173
Mailing address
4 ROSS CT, MOUNT SINAI, NY 11766-2515
(224) 406-1577
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
111292-01
NY
Other
Enumeration date
01/28/2021
Last updated
01/28/2021
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