Individual
SUSANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1012 BROAD ST, BLOOMFIELD, NJ 07003-2807
(973) 338-1244
(973) 338-1544
Mailing address
1012 BROAD ST, BLOOMFIELD, NJ 07003-2807
(973) 338-1244
(973) 338-1544
Taxonomy
Speciality
Code
Description
License number
State
106H00000X
Marriage & Family Therapist
Primary
37PC00470400
NJ
Other
Enumeration date
09/04/2014
Last updated
09/04/2014
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