Provider Information for 1225808884
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DIANE MARIE CANTWELL LMHC
Sex: Female
NPI: 1225808884
Last Updated: 2024-01-05
Certification Date: 2024-01-05
Certification Date: 2024-01-05
Details
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NPI | 1225808884 | ||||||||||||
Enumeration Date | 2024-01-04 | ||||||||||||
NPI Type | NPI-1 Individual | ||||||||||||
Sole Proprietor | YES | ||||||||||||
Status | Active | ||||||||||||
Mailing Address | 94 BLACK EYED SUSAN RD LANGHORNE, PA 19047-3418 United States Phone: 818-505-4328 | Fax: | ||||||||||||
Primary Practice Address | 15816 COBBLE MILL DR WIMAUMA, FL 33598-4011 United States Phone: 818-505-4328 | Fax: | ||||||||||||
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