Individual
ANNA JULIET DIAZ-POORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPCF
Contact information
Practice address
614 N EASTON RD, GLENSIDE, PA 19038-4301
(215) 884-9770
(215) 884-6130
Mailing address
614 N EASTON RD, GLENSIDE, PA 19038-4301
(215) 884-9770
(215) 884-6130
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
Primary
PC003405
PA
Other
Enumeration date
08/30/2009
Last updated
08/30/2009
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