Individual
DIANE ICE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
315 MULBERRY ST, EVANSVILLE, IN 47713-1252
(812) 421-7489
(812) 436-0209
Mailing address
315 MULBERRY ST, EVANSVILLE, IN 47713-1252
(812) 421-7489
(812) 436-0209
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
33005841A
IN
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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