Provider Demographics
NPI:1891193652
Name:MEYER, DIANA (MSW)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:MEYER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2161 NW MILITARY HWY
Mailing Address - Street 2:SUITE 308
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78213-1878
Mailing Address - Country:US
Mailing Address - Phone:210-341-3336
Mailing Address - Fax:
Practice Address - Street 1:SCOTT AFB
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:62225
Practice Address - Country:US
Practice Address - Phone:618-256-1110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO0013891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical