Provider Demographics
NPI:1952736001
Name:DIOGUARDI, ROSE ANNE (LICSW)
Entity Type:Individual
Prefix:MISS
First Name:ROSE ANNE
Middle Name:
Last Name:DIOGUARDI
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HAZEL TER APT 5
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-4631
Mailing Address - Country:US
Mailing Address - Phone:978-335-3540
Mailing Address - Fax:
Practice Address - Street 1:1 HAZEL TER APT 5
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-4631
Practice Address - Country:US
Practice Address - Phone:978-335-3540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1160121041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical