Individual
MICHAEL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.ED.
Contact information
Practice address
440 CERRILLOS RD, SANTA FE, NM 87501-2686
(505) 982-6201
Mailing address
PO BOX 1092, SANTA FE, NM 87504-1092
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
1690
NM
Other
Enumeration date
01/14/2008
Last updated
01/14/2008
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