SUSAN DIANE ANDERSON

LA PORTE, IN
NPI1922113919
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy1041C0700X Social Worker, Clinical
(Licence: IN  34000100)
Additional Taxonomies104100000X Social Worker
(Licence: IN  34000100)
Enumeration Date2006-08-20
Last Update Date2007-07-08
Business Address
-- SUSAN DIANE ANDERSON LCSW
318 PINE LAKE AVE
LA PORTE, IN 46350-3061
Phone number: 219-324-6263
Mailing Address
-- SUSAN DIANE ANDERSON LCSW
PO BOX 668
LA PORTE, IN 46352-0668
Phone number: 219-324-6263