Individual
MARK DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4009 6TH AVE STE 11, KEARNEY, NE 68845-0377
(308) 627-6302
Mailing address
615 N ELM ST, GRAND ISLAND, NE 68801-4254
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
11/11/2024
Last updated
11/11/2024
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