Individual
AMANDA J DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
2450 W RIDGE RD STE 304A, ROCHESTER, NY 14626-3037
(315) 975-9450
Mailing address
2450 W RIDGE RD STE 304A, ROCHESTER, NY 14626-3037
(315) 975-9450
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NY
104100000X
Social Worker
098993-1
NY
1041C0700X
Clinical Social Worker
Primary
094633-01
NY
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01420800
—
NY
Enumeration date
08/31/2010
Last updated
09/27/2023
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