Provider Demographics
NPI:1760662050
Name:BRAMAN, DIANE LYNNE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DIANE
Middle Name:LYNNE
Last Name:BRAMAN
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:PO BOX 334
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:MS
Mailing Address - Zip Code:39073-0334
Mailing Address - Country:US
Mailing Address - Phone:601-759-1970
Mailing Address - Fax:
Practice Address - Street 1:499 KEYWOOD CIR STE B
Practice Address - Street 2:
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-3001
Practice Address - Country:US
Practice Address - Phone:601-759-1970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-05
Last Update Date:2020-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSC62851041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical