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Individual

MR. SAMUEL DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.

Contact information

Practice address
45 WARDSWORTH ST., HARTFORD, CT 06106
(860) 527-1124
(860) 724-2539
Mailing address
45 WADSWORTH ST, HARTFORD, CT 06106-7108
(860) 527-1124
(860) 724-2539

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
08/05/2011
Last updated
08/05/2011
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