Individual
DIOGO MACHADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.A., LASAC
Contact information
Practice address
152 N 56TH ST, MESA, AZ 85205-8718
(602) 368-4471
Mailing address
152 N 56TH ST, MESA, AZ 85205-8718
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
LASAC-15094
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LASAC-15094
ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS
AZ
Enumeration date
10/07/2015
Last updated
10/07/2015
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