Provider Demographics
NPI:1689691529
Name:WHISLER, DIANE MAREE (MSW LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MAREE
Last Name:WHISLER
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3621 W KENT DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85226-1312
Mailing Address - Country:US
Mailing Address - Phone:480-786-6790
Mailing Address - Fax:
Practice Address - Street 1:20185 E OCOTILLO RD
Practice Address - Street 2:
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242-8799
Practice Address - Country:US
Practice Address - Phone:480-987-2700
Practice Address - Fax:480-982-2449
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-10963101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional