Individual
MISS KATHLEEN I DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 MAINE ST STE A, LAWRENCE, KS 66044-1396
(785) 843-9192
Mailing address
200 MAINE ST STE A, LAWRENCE, KS 66044-1396
Taxonomy
Speciality
Code
Description
License number
State
103TF0000X
Family Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103T00000X
BLUE CROSS BLUE SHIELD
KS
05
—
103T00000X
—
KS
Enumeration date
11/06/2018
Last updated
11/07/2018
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