Provider Demographics
NPI:1831440288
Name:TOWNSEL, DIANE SUE (MSW)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:SUE
Last Name:TOWNSEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:SUE
Other - Last Name:DAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:22600 THORNCLIFFE ST
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-6550
Mailing Address - Country:US
Mailing Address - Phone:248-809-2254
Mailing Address - Fax:
Practice Address - Street 1:22600 THORNCLIFFE ST
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48033-6550
Practice Address - Country:US
Practice Address - Phone:248-809-2254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-25
Last Update Date:2012-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801093462171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator