Provider Demographics
NPI:1750457289
Name:ALTHER, DIANE GAIL (MSW LCSW RN)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:GAIL
Last Name:ALTHER
Suffix:
Gender:F
Credentials:MSW LCSW RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1296
Mailing Address - Street 2:
Mailing Address - City:DUNNELLON
Mailing Address - State:FL
Mailing Address - Zip Code:34430
Mailing Address - Country:US
Mailing Address - Phone:352-425-1992
Mailing Address - Fax:352-465-2118
Practice Address - Street 1:108 N MAGNOLIA AVE
Practice Address - Street 2:SUITE 505
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34475
Practice Address - Country:US
Practice Address - Phone:352-425-1992
Practice Address - Fax:352-465-2118
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW79011041C0700X
NYR0407981041C0700X
NY2325091163W00000X
FLRN9254860163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL299205OtherAMERIGROUP
FL2089EOtherBC BSF
FL7480250OtherGHI
FL056612OtherVALUE OPTIONS
FL11545795OtherAETNA
FL9285642OtherPHCS
FL203795OtherMHN
FL2089EOtherBC BSF
NYN5H141Medicare UPIN