Individual
CHARLEEN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
771 LUCAYA DR, KISSIMMEE, FL 34758-3279
(321) 900-5159
Mailing address
771 LUCAYA DR, KISSIMMEE, FL 34758-3279
(321) 900-5159
Taxonomy
Speciality
Code
Description
License number
State
103TH0004X
Health Psychologist
Primary
—
—
103TR0400X
Rehabilitation Psychologist
—
—
Other
Enumeration date
08/17/2019
Last updated
08/17/2019
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