Individual
DIANE POWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
550 W FRONTAGE RD STE 2810, NORTHFIELD, IL 60093-1239
(847) 461-9096
Mailing address
1306 ASHLAND AVE, WILMETTE, IL 60091-1608
(847) 256-2216
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
149-005446
IL
Other
Enumeration date
11/04/2017
Last updated
11/04/2017
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