Provider Demographics
NPI:1477889012
Name:GAWEDZINSKI, DIANE BARNES (LPC)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:BARNES
Last Name:GAWEDZINSKI
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MISS
Other - First Name:DIANE
Other - Middle Name:MOLLIE
Other - Last Name:BARNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 381852
Mailing Address - Street 2:
Mailing Address - City:DUNCANVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75138-1852
Mailing Address - Country:US
Mailing Address - Phone:214-293-8090
Mailing Address - Fax:903-896-4846
Practice Address - Street 1:1106 SANTA FE TRL
Practice Address - Street 2:SUITE 6
Practice Address - City:DUNCANVILLE
Practice Address - State:TX
Practice Address - Zip Code:75137-3063
Practice Address - Country:US
Practice Address - Phone:214-293-8090
Practice Address - Fax:903-896-4846
Is Sole Proprietor?:No
Enumeration Date:2009-11-01
Last Update Date:2009-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63510101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional