Individual
BRENDA RUSSELL-DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
5348 ARCHSTONE DR APT 204, TAMPA, FL 33634-4219
(610) 621-6434
Mailing address
5348 ARCHSTONE DR APT 204, TAMPA, FL 33634-4219
(610) 621-6434
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MH25907
FL
101YS0200X
School Counselor
1437674
FL
Other
Enumeration date
06/11/2025
Last updated
06/11/2025
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