Provider Demographics
NPI:1649381948
Name:JULES, DIANE CHERRIEMAE (LMSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:CHERRIEMAE
Last Name:JULES
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:CHERRIEMAE
Other - Last Name:CLARKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:7400 MERTON MINTER ST # 671122
Mailing Address - Street 2:AUDIE L. MURPHY VA HOSPITAL
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7400 MERTON MINTER ST
Practice Address - Street 2:AUDIE L. MURPHY VA HOSPITAL 671/122
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-4404
Practice Address - Country:US
Practice Address - Phone:210-949-3065
Practice Address - Fax:210-617-5332
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX378821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX671OtherAUDIE MURPHY VA HOSPITAL