Individual
NANCY DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
11711 MYRTLE AVE, RICHMOND HILL, NY 11418-1751
(718) 849-6300
Mailing address
11711 MYRTLE AVE, RICHMOND HILL, NY 11418-1751
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21691
NY
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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