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NPI Code Detail

MEDICARE: LYNN DIAZ

MEDICARE:   LYNN  DIAZ
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1013387596
Entity Type Code : Individual
Provider Name (Legal Business Name) : LYNN DIAZ
Provider Business Mailing Address
First Line : 5518 S CINCINNATI AVE
Second Line :
City : TULSA
State : OK
Zip : 74105-6706
Country : US
Telephone Number : 918-519-0651
Fax Number :
Provider Business Practice Location Address
First Line : 5518 S CINCINNATI AVE
Second Line :
City : TULSA
State : OK
Zip : 74105-6706
Country : US
Telephone Number : 918-519-0651
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/28/2015
Last Update Date : 09/28/2015

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Directions to “ LYNN DIAZ ” Practice Location

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