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Individual
MR. TEODORO ANDERSON-DIAZ
Active
Individual
MR. TEODORO ANDERSON-DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW,LADC,
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000554
CT
1041C0700X
Clinical Social Worker
Primary
006712
CT
Other
Enumeration date
08/22/2006
Last updated
02/08/2012
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