Most Relevant Information
Provider Data
| NPI Number: | 1003021437 |
| Provider Name: | DIANA JO LEIGH LISW |
| Entity Type: | Individual |
| Taxonomy Code: | 1041C0700X |
| Specialty: | Social Worker |
| License Number: | 0003886 |
Most Important Dates
| Enumeration Date: | 05/11/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
24100 CHAGRIN BLVD
SUITE 370
BEACHWOOD
OH
441225535
Practice Location Phone/Fax
| Phone: | 2162926520 |
| Fax: | 2168312351 |
Provider Mailing Location
3707 TOWNLEY RD
SHAKER HEIGHTS
OH
441225121
Provider Mailing Phone/Fax
| Phone: | 2162831946 |
| Fax: | 2162831946 |