DIANE MARGARET VAN CORNEWAL

FLAGSTAFF, AZ
NPI1821437500
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy101YM0800X Counselor Mental Health
(Licence: AZ  LCSW-10760)
Additional Taxonomies101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: AZ  LISAC-10581)
Enumeration Date2013-06-17
Last Update Date2013-06-17
Business Address
DIANE MARGARET VAN CORNEWAL LCSW LISAC
1215 N BEAVER ST FLAGSTAFF MEDICAL CENTER
FLAGSTAFF, AZ 86001-3126
Phone number: 928-213-6415
Mailing Address
DIANE MARGARET VAN CORNEWAL LCSW LISAC
1215 N BEAVER ST FLAGSTAFF MEDICAL CENTER
FLAGSTAFF, AZ 86001-3126
Phone number: 928-213-6415