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1972024347
LISSET J DIAZ
JOPLIN, MO
NPI
1972024347
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: MO 2017022320)
Enumeration Date
2017-07-06
Last Update Date
2017-07-06
Business Address
LISSET J DIAZ
932 E 34TH ST
JOPLIN, MO 64804-3932
Phone number: 417-347-5800
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Mailing Address
LISSET J DIAZ
PO BOX 2526
JOPLIN, MO 64803-2526
Phone number: 417-347-7579
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