Doctor Name: | MS. MARISSA ALICIA DIAZ |
NPI Number: | 1821303975 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 6000 Palm Trace Landing Dr Apt 204 Davie, FL - 333141835 |
Business Phone Number: | 9548545532 |
Business Fax Number: | |
Mailing Address: | 3500 N State Road 7, Suite 211 LAUDERDALE LAKES |
State: | FL |
Postal Code: | 333195600 |
Phone Number: | 9549788399 |
Fax Number: | 9545780145 |
NPI Enumeration Date: | 08/13/2010 |
NPI Last Update Date: | 08/13/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101Y00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider who is trained and educated in the performance of behavior health services through interpersonal communications and analysis. Training and education at the specialty level usually requires a master |