Provider Demographics
NPI:1629033063
Name:WINSLOW, DIANA (MSW)
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:WINSLOW
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:MS
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:WINSLOW
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:14901 NORTH PENNSYLVANIA AVENUE
Mailing Address - Street 2:SUITE #222-B
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-6074
Mailing Address - Country:US
Mailing Address - Phone:405-203-6976
Mailing Address - Fax:
Practice Address - Street 1:1607 N.E. 23RD STREET
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73111-3243
Practice Address - Country:US
Practice Address - Phone:405-203-6976
Practice Address - Fax:405-535-5835
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK209961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical