Individual
MS. MARISSA ALICIA DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6000 PALM TRACE LANDING DR, APT 204, DAVIE, FL 33314-1835
(954) 854-5532
Mailing address
3500 N STATE ROAD 7, SUITE 211, LAUDERDALE LAKES, FL 33319-5600
(954) 978-8399
(954) 578-0145
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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