Provider Demographics
NPI:1659673960
Name:LEE-RANDALL, DIANA S (LMSW)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:S
Last Name:LEE-RANDALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 ARCAMPUS DR
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14612-3630
Mailing Address - Country:US
Mailing Address - Phone:585-225-9720
Mailing Address - Fax:585-225-6898
Practice Address - Street 1:20 ARCAMPUS DR
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14612-3630
Practice Address - Country:US
Practice Address - Phone:585-225-9720
Practice Address - Fax:585-225-6898
Is Sole Proprietor?:No
Enumeration Date:2010-11-19
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical