| NPI | 1558431650 |
|---|---|
| Former Name | DIANA YVONNE CERVONE |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: FL SW 8747) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MA 111950) |
| 103TS0200X Psychologist School (Licence: FL SS 924) | |
| 103TS0200X Psychologist School (Licence: MA ED PSY 963 ALLIED MH) | |
| Enumeration Date | 2006-11-08 |
| Last Update Date | 2013-09-24 |