Individual
LAURA M DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D.
Contact information
Practice address
859 WILLARD ST, QUINCY, MA 02169-7482
(617) 847-1950
(617) 774-1490
Mailing address
859 WILLARD ST, QUINCY, MA 02169-7482
(617) 847-1950
(617) 774-1490
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
9968
MA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
02/29/2012
Last updated
09/18/2014
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