Provider Demographics
NPI:1407611064
Name:TURK, DIANE (MSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:TURK
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 1:4333 N WATERCREST DR
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-3185
Mailing Address - Country:US
Mailing Address - Phone:567-277-7339
Mailing Address - Fax:
Practice Address - Street 1:33200 DEQUINDRE RD STE 100
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-5967
Practice Address - Country:US
Practice Address - Phone:586-354-1489
Practice Address - Fax:586-698-2907
Is Sole Proprietor?:No
Enumeration Date:2024-02-13
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011174821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical