Provider Demographics
NPI:1912036559
Name:SASSER, DIANE (LMHC)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:SASSER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:
Other - Last Name:ESCOBAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4740 N. STATE ROAD 7
Mailing Address - Street 2:
Mailing Address - City:LAUDERDALE LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33319
Mailing Address - Country:US
Mailing Address - Phone:954-486-4005
Mailing Address - Fax:
Practice Address - Street 1:2677 NW 19TH ST
Practice Address - Street 2:
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33311-3340
Practice Address - Country:US
Practice Address - Phone:954-739-7970
Practice Address - Fax:954-497-3857
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2017-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator