Provider Demographics
NPI:1013213966
Name:SCOTLAND-COOGAN, DIANE (MSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:
Last Name:SCOTLAND-COOGAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12709 RIDGEVIEW CT
Mailing Address - Street 2:
Mailing Address - City:DADE CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33525-6221
Mailing Address - Country:US
Mailing Address - Phone:352-238-6126
Mailing Address - Fax:
Practice Address - Street 1:12709 RIDGEVIEW CT
Practice Address - Street 2:
Practice Address - City:DADE CITY
Practice Address - State:FL
Practice Address - Zip Code:33525-6221
Practice Address - Country:US
Practice Address - Phone:352-238-6126
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-09
Last Update Date:2011-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical