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Individual

LIADYS DIAZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MASW

Contact information

Practice address
4 SYCAMORE CT APT 102, WINTER SPRINGS, FL 32708
(787) 394-1051
Mailing address
4630 COMMANDER DR APT 1027, ORLANDO, FL 32822-3512
(787) 394-1051

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
106S00000X
Behavior Technician
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
D262-521-93-681-0
DRIVER LICENSE
FL
Enumeration date
12/05/2016
Last updated
05/15/2018
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