Provider Demographics
NPI:1992032684
Name:JONES, DIANE MARIE
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:MARIE
Last Name:JONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 QUINCY ST NE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-2615
Mailing Address - Country:US
Mailing Address - Phone:240-602-2357
Mailing Address - Fax:202-397-3296
Practice Address - Street 1:1325 QUINCY ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-2615
Practice Address - Country:US
Practice Address - Phone:240-602-2357
Practice Address - Fax:202-397-3296
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-17
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3028211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical