Individual
LISA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
7601 PARLANE RD, COLUMBIA, SC 29223
(803) 741-9090
Mailing address
7601 PARKLANE RD, COLUMBIA, SC 29223-6122
(803) 741-9090
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1986
SC
Other
Enumeration date
05/20/2016
Last updated
05/20/2016
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