Organization
COURAGEOUS NEW DIRECTIONS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. KAMI LEA DIAZ LCSW-S (OWNER)
(254) 392-0118
Entity
Organization
Contact information
Practice address
202 W CENTRAL TEXAS EXPY STE 206, KILLEEN, TX 76541-8902
(254) 392-0118
Mailing address
451D E CENTRAL TEXAS EXPY # 304, HARKER HEIGHTS, TX 76548-1962
(254) 392-0118
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39784
LICENSED CLINICAL SOCIAL WORK SUPERVISOR
TX
Enumeration date
07/11/2019
Last updated
07/11/2019
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