Individual
TOMAS DIAZ SR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHS, LCADC
Contact information
Practice address
220 MARKET ST, PERTH AMBOY, NJ 08861-4331
(732) 709-7440
(732) 709-0147
Mailing address
220 MARKET ST, PERTH AMBOY, NJ 08861-4331
(732) 709-7440
(732) 709-0147
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37LC00156200
NJ
Other
Enumeration date
06/08/2015
Last updated
06/08/2015
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