Individual
CAROLYN PERRY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
1898 FORT RD, BUILDING 64, SHERIDAN, WY 82801-8320
(307) 672-3473
Mailing address
1898 FORT RD, HOUSE 14A, SHERIDAN, WY 82801-8320
(307) 674-6755
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C000312
NC
Other
Enumeration date
02/07/2007
Last updated
07/08/2007
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