Provider Demographics
NPI:1477178101
Name:ROWAN, DIANA (PHD, MSW, LCSW)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:ROWAN
Suffix:
Gender:F
Credentials:PHD, MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2004 ATHERTON DR
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-5661
Mailing Address - Country:US
Mailing Address - Phone:704-965-1699
Mailing Address - Fax:
Practice Address - Street 1:2004 ATHERTON DR
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-5661
Practice Address - Country:US
Practice Address - Phone:704-965-1699
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-09
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0061741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical