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Individual

JOSE L DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
3700 JOSEPH SIEWICK DR STE 408A, FAIRFAX, VA 22033-1745
(703) 391-3300
(703) 391-4380
Mailing address
3700 JOSEPH SIEWICK DR STE 408A, FAIRFAX, VA 22033-1745
(703) 391-3300
(703) 391-4380

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MH 10445
FL
101YP2500X
Professional Counselor
Primary
0701007329
VA

Other

Enumeration date
10/18/2010
Last updated
08/24/2021
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