Individual
DR. DAYNA M.V. DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH.D.
Contact information
Practice address
1770 OLD SPRING HOUSE LN, SUITE 114, ATLANTA, GA 30338-6213
(770) 452-5353
(770) 452-5363
Mailing address
1770 OLD SPRING HOUSE LN, SUITE 114, ATLANTA, GA 30338-6213
(770) 452-5353
(770) 452-5363
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PSY002970
GA
103TC2200X
Clinical Child & Adolescent Psychologist
PSY002970
GA
103TP2701X
Group Psychotherapy Psychologist
PSY002970
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10059861
AMERIGROUP PROVIDER NUMBE
GA
01
—
103882
PEACHSTATE CENPATICO
GA
Enumeration date
01/12/2007
Last updated
09/10/2007
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