Individual
MRS. DIANE MARIE PALACIOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC , LISAC
Contact information
Practice address
3001 N 33RD AVE, PHOENIX, AZ 85017-5202
(602) 353-0703
(602) 353-0715
Mailing address
PO BOX 90336, PHOENIX, AZ 85066-0336
(602) 279-7655
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LISAC-15026
AZ
101YM0800X
Mental Health Counselor
Primary
—
—
101YP2500X
Professional Counselor
LPC-15559
AZ
Other
Enumeration date
02/23/2009
Last updated
05/17/2024
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