Provider Demographics
NPI:1003039827
Name:ROWE, DIANE B (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:B
Last Name:ROWE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 N MALL DR APT 10
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-8178
Mailing Address - Country:US
Mailing Address - Phone:435-673-1569
Mailing Address - Fax:435-673-1569
Practice Address - Street 1:321 N MALL DR
Practice Address - Street 2:BLDG I 102
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7302
Practice Address - Country:US
Practice Address - Phone:435-652-9428
Practice Address - Fax:435-673-1569
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT277799-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical