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1588392070
DIANE M PARK
TEANECK, NJ
NPI
1588392070
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: NJ 44SL06829700)
Enumeration Date
2022-08-11
Last Update Date
2022-08-11
Business Address
DIANE M PARK LSW
179 CEDAR LN STE C
TEANECK, NJ 07666-4304
Phone number: 201-505-8972
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Mailing Address
DIANE M PARK LSW
86 MADISON ST APT 207
PARK RIDGE, NJ 07656-1383
Phone number: 201-388-7666
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