Provider Demographics
NPI:1225760549
Name:LITWIN, DIANE M (BSN, RN, IBCLC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:M
Last Name:LITWIN
Suffix:
Gender:F
Credentials:BSN, RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8730 MAPLEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT AIRY
Mailing Address - State:MD
Mailing Address - Zip Code:21771-9704
Mailing Address - Country:US
Mailing Address - Phone:301-529-5433
Mailing Address - Fax:
Practice Address - Street 1:708 PINE ST
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-4603
Practice Address - Country:US
Practice Address - Phone:301-529-5433
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001256162163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant