Provider Demographics
NPI:1144733080
Name:KNIPP, DIANNE L (MSW, LISW-S)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:L
Last Name:KNIPP
Suffix:
Gender:F
Credentials:MSW, LISW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:832 ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BUCYRUS
Mailing Address - State:OH
Mailing Address - Zip Code:44820-2739
Mailing Address - Country:US
Mailing Address - Phone:567-876-2547
Mailing Address - Fax:
Practice Address - Street 1:136 W CENTER ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:OH
Practice Address - Zip Code:43302-3704
Practice Address - Country:US
Practice Address - Phone:740-751-6380
Practice Address - Fax:740-751-4866
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-14
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI.17006961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical