Provider Demographics
NPI:1679046031
Name:ZINNIE, DIANA MARIE (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:MARIE
Last Name:ZINNIE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1516 JOHNNY'S WAY
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382
Mailing Address - Country:US
Mailing Address - Phone:484-686-0711
Mailing Address - Fax:610-383-0264
Practice Address - Street 1:1400 BLACKHORSE HILL ROAD
Practice Address - Street 2:
Practice Address - City:COATESVILLE
Practice Address - State:PA
Practice Address - Zip Code:19320
Practice Address - Country:US
Practice Address - Phone:610-384-7711
Practice Address - Fax:610-383-0264
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0167211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical