| NPI | 1801142799 |
|---|---|
| Former Name | AIDA IRIS DIAZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 2692) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2012-07-27 |
| Last Update Date | 2020-12-21 |