Provider Demographics
NPI:1144270943
Name:HERRMANN, DIANA LYNN (MSW, LISW)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LYNN
Last Name:HERRMANN
Suffix:
Gender:F
Credentials:MSW, LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 HUNTERS HL
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:KY
Mailing Address - Zip Code:41001-8576
Mailing Address - Country:US
Mailing Address - Phone:859-635-6623
Mailing Address - Fax:
Practice Address - Street 1:VA MEDICAL CENTER
Practice Address - Street 2:3200 VINE STREET
Practice Address - City:CINCINNATI
Practice Address - State:OK
Practice Address - Zip Code:45220
Practice Address - Country:US
Practice Address - Phone:859-392-3844
Practice Address - Fax:859-392-3841
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00050861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical