Individual
DIANE EE MARINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PFP
Contact information
Practice address
21278 E AVENIDA DEL VALLE, QUEEN CREEK, AZ 85242-6919
(480) 641-8622
(480) 325-0177
Mailing address
21278 E AVENIDA DEL VALLE, QUEEN CREEK, AZ 85242-6919
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3925
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
720400
A5 -THRP FOSTER CARE HOME
AZ
Enumeration date
12/20/2006
Last updated
07/08/2007
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