Individual
GENESIS DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW
Contact information
Practice address
653 25TH ST, OGDEN, UT 84401-2644
(646) 321-1346
Mailing address
3375 HARRISON BLVD, OGDEN, UT 84403-1228
(646) 321-1346
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
12231686-3502
UT
Other
Enumeration date
06/22/2021
Last updated
08/19/2021
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