Individual
DIANE CLODI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
4240 FLORIAN AVENUE, BUILDING 1, MESA, AZ 85206
(480) 844-1653
Mailing address
4240 FLORIAN AVE., MESA, AZ 85206
(480) 844-1653
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
108005379
IL
101YP2500X
Professional Counselor
Primary
5439T
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634997
BCBS NUMBER
IL
Enumeration date
08/24/2006
Last updated
06/11/2013
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