Diane Gardner | Waltham, MA • PECOS Search

Diane Gardner

Social Worker

Behavioral Health & Social Service Providers

1430 Main St, Waltham, MA 02451-1623

(781) 647-5327 (781) 223-6473

PECOS Enrollment

Based on the most recent information from CMS, provider Diane Gardner does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 10:04 AM.

Profile Details

Provider ID
1205317823
Provider Type
Individual
Full Name
Gardner, Diane
Gender
Female

Sole Proprietor
No
Enumeration Date
8/22/2018
Last Updated
8/22/2018

Contact Information

Practice Location

1430 Main St, Waltham, MA 02451-1623

Unlisted Fax

Mailing Location

15 Linden St, Arlington, MA 02476-5913

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 119263 Massachusetts