Diane Colonnello,lcsw,pa | |
8192 College Pkwy Ste. 50 Fort Myers FL 33919-5175 | |
(239) 275-9665 | |
(239) 267-4438 |
Full Name | Diane Colonnello,lcsw,pa |
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Speciality | Social Worker - Clinical |
Location | 8192 College Pkwy, Fort Myers, Florida |
Authorized Official Name and Position | Diane Colonnello (PRESIDENT) |
Authorized Official Contact | 2392759665 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Diane Colonnello,lcsw,pa 8192 College Pkwy Ste. 50 Fort Myers FL 33919-5175 Ph: (239) 275-9665 | Diane Colonnello,lcsw,pa 8192 College Pkwy Ste. 50 Fort Myers FL 33919-5175 Ph: (239) 275-9665 |
NPI Number | 1629378898 |
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Provider Enumeration Date | 10/22/2010 |
Last Update Date | 10/22/2010 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629378898 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | SW1700 (Florida) | Primary |
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