Individual
JENNIFER DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
632 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701-6834
(407) 875-5704
Mailing address
632 MAITLAND AVE, ALTAMONTE SPRINGS, FL 32701-6834
(407) 875-5704
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
106H00000X
Marriage & Family Therapist
Primary
IMT3002
FL
106H00000X
Marriage & Family Therapist
—
—
Other
Enumeration date
09/18/2020
Last updated
09/18/2020
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