Individual
JENNIFER A DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
415 E MADISON ST, SOUTH BEND, IN 46617-2322
(574) 533-1234
Mailing address
PO BOX 809, GOSHEN, IN 46527-0809
(574) 533-1234
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
39005768A
IN
Other
Enumeration date
01/21/2026
Last updated
01/21/2026
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