Provider Demographics
NPI:1275870602
Name:GARLAND, DIANE E (LCSW, ACHP-S)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:GARLAND
Suffix:
Gender:F
Credentials:LCSW, ACHP-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4725 NORTH FEDERAL HIGHWAY
Mailing Address - Street 2:PALLIATIVE CARE
Mailing Address - City:FT. LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33308
Mailing Address - Country:US
Mailing Address - Phone:954-351-5895
Mailing Address - Fax:561-395-0359
Practice Address - Street 1:4725 NORTH FEDERAL HIGHWAY
Practice Address - Street 2:PALLIATIVE CARE
Practice Address - City:FT. LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33308
Practice Address - Country:US
Practice Address - Phone:954-351-5895
Practice Address - Fax:561-395-0359
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-04
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW19681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical