Provider Demographics
NPI:1366615155
Name:AMANN, DIANA JOHNSON (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:JOHNSON
Last Name:AMANN
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16210 RAWLINGS HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:RAWLINGS
Mailing Address - State:MD
Mailing Address - Zip Code:21557-1010
Mailing Address - Country:US
Mailing Address - Phone:301-729-0530
Mailing Address - Fax:
Practice Address - Street 1:134 BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:CUMBERLAND
Practice Address - State:MD
Practice Address - Zip Code:21502-2302
Practice Address - Country:US
Practice Address - Phone:301-777-0620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-11
Last Update Date:2008-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD13631104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker