Individual
JOANN DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
86 WATCH TOWER RD, PLYMOUTH, CT 06782-2811
(860) 485-4931
Mailing address
86 WATCH TOWER RD, PLYMOUTH, CT 06782-2811
(860) 485-4931
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
00
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00
NA
—
01
—
E48393
RN-PSYCHIATRIC/MENTAL HEALTH
CT
Enumeration date
07/05/2022
Last updated
07/05/2022
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