Provider Information for 1669191177
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DIANNE RICH LCSW
Sex: Female
NPI: 1669191177
Last Updated: 2022-08-26
Certification Date: 2022-08-26
Certification Date: 2022-08-26
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1669191177 | ||||||||
| Enumeration Date | 2022-08-26 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2022 MICHIGAN AVE PANAMA CITY, FL 32405-1825 United States Phone: 850-276-1693 | Fax: | ||||||||
| Primary Practice Address | 2022 MICHIGAN AVE PANAMA CITY, FL 32405-1825 United States Phone: 850-276-1693 | Fax: | ||||||||
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