Provider Demographics
NPI:1700918927
Name:SMITH, DIANNA LEE (MSW)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:LEE
Last Name:SMITH
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 1:49 CUMMINGS RD
Mailing Address - Street 2:
Mailing Address - City:BREWSTER
Mailing Address - State:MA
Mailing Address - Zip Code:02631-2567
Mailing Address - Country:US
Mailing Address - Phone:617-771-0210
Mailing Address - Fax:
Practice Address - Street 1:49 CUMMINGS RD
Practice Address - Street 2:
Practice Address - City:BREWSTER
Practice Address - State:MA
Practice Address - Zip Code:02631-2567
Practice Address - Country:US
Practice Address - Phone:617-771-0210
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2021-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health