Bracamontes, Diane
Bracamontes, Diane is an sole proprietor health care provider with primary practice located at 2016 Vadalabene Dr Ste A , Maryville IL 62062-6901. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bracamontes, Diane can be contacted via phone (618) 823-6444.Contact Information
Primary practice address
2016 Vadalabene Dr Ste A
Maryville IL 62062-6901
Phone: (618) 823-6444
Fax: (618) 551-8456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 149013539 | Illinois |
Profile Details
| NPI number | 1306089974 |
|---|---|
| LBN Legal business name | Bracamontes, Diane |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2009 |
| Last updated | Mar 8th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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