Provider Demographics
NPI:1962681957
Name:MILLER, DIANE WEGER (LCSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:WEGER
Last Name:MILLER
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 1:620 WEYGADT DR
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-1625
Mailing Address - Country:US
Mailing Address - Phone:610-216-9405
Mailing Address - Fax:610-253-6088
Practice Address - Street 1:133 N 4TH ST
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-3518
Practice Address - Country:US
Practice Address - Phone:610-349-3836
Practice Address - Fax:610-258-1268
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0155361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical