Individual
AMY DIAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2375 GIANNONI WAY, LODI, CA 95242-4795
(209) 331-8391
Mailing address
1305 E VINE ST, LODI, CA 95240-3179
(209) 331-7000
Taxonomy
Speciality
Code
Description
License number
State
103TS0200X
School Psychologist
Primary
210109942
CA
Other
Enumeration date
07/18/2018
Last updated
07/26/2024
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