Provider Demographics
NPI:1710452883
Name:KUZIA HILLS, DIANNE (LICSW)
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:KUZIA HILLS
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:LYNN
Mailing Address - State:MA
Mailing Address - Zip Code:01901-1109
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:781-595-0113
Practice Address - Street 1:98 WILLOW ST
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01901-1109
Practice Address - Country:US
Practice Address - Phone:781-595-3224
Practice Address - Fax:781-595-0113
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2018-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1134151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA113415OtherSTATE LICENSING BOARD