Individual
LUIS A. DIAZ SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
90 MADISON ST STE 502, WORCESTER, MA 01608-2058
(774) 530-6363
(774) 530-6364
Mailing address
19 VINSON ST , #3, WORCESTER, MA 01605
(774) 441-4501
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
MA
Other
Enumeration date
08/25/2023
Last updated
08/25/2023
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