Individual
MS. SUSANA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15033 DREAM CT, EL PASO, TX 79938-4690
(915) 383-2823
Mailing address
15033 DREAM CT, EL PASO, TX 79938-4690
(915) 383-2823
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
67002
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33906710
MULTIPLE
TX
Enumeration date
06/04/2022
Last updated
06/04/2022
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