Individual
AMANDA A DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5305 MCNUTT RD, SANTA TERESA, NM 88008-9685
(575) 882-5100
(575) 882-1151
Mailing address
1219 BARRANCA DR, EL PASO, TX 79935-4601
(915) 779-5600
(915) 779-5605
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
0150901
NM
Other
Enumeration date
07/10/2012
Last updated
07/10/2012
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