Individual
MRS. VIRGINIA L DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMFT/LPCA
Contact information
Practice address
200 DOCTORS DR STE C, JACKSONVILLE, NC 28546-6308
(910) 546-7647
Mailing address
168 DOCKSIDE DRIVE, JACKSONVILLE, NC 28546
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
A12437
NC
106H00000X
Marriage & Family Therapist
Primary
1887
NC
Other
Enumeration date
08/28/2016
Last updated
08/26/2017
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