Individual
THALIA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
555 S GALLERIA WAY UNIT 397, CHANDLER, AZ 85226-1544
(480) 420-6741
Mailing address
PO BOX 7516, CHANDLER, AZ 85246-7516
(480) 420-6741
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
9659
CA
106H00000X
Marriage & Family Therapist
122000
CA
106H00000X
Marriage & Family Therapist
Primary
LMFT-15769
AZ
106H00000X
Marriage & Family Therapist
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Other
Enumeration date
10/11/2017
Last updated
12/01/2022
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