Provider Demographics
NPI:1295896777
Name:WAHLERS, DIANE LARLEE (MSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:LARLEE
Last Name:WAHLERS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 RIVERCLIFF DR
Mailing Address - Street 2:
Mailing Address - City:ATHENS
Mailing Address - State:GA
Mailing Address - Zip Code:30607-2052
Mailing Address - Country:US
Mailing Address - Phone:706-549-7199
Mailing Address - Fax:706-549-7199
Practice Address - Street 1:151 RIVERCLIFF DR
Practice Address - Street 2:
Practice Address - City:ATHENS
Practice Address - State:GA
Practice Address - Zip Code:30607-2052
Practice Address - Country:US
Practice Address - Phone:706-549-7199
Practice Address - Fax:706-549-7199
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator