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General NPI Number Information
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NPI Number | 1093434391
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Entity Type | Organization
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Legal Business Name | SANDRA DIAZ CONSULTING LLC
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Dates
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Enumeration Date | 08/22/2022
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Last Update Date | 04/16/2024
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Provider Practice Location Address
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Address Line | 7 AEWA PL STE 7
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City | MAKAWAO
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State | HI
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Zip | 96768-8882
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Country | US
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Telephone | 808-298-6592
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Fax | 808-633-8527
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Provider Business Mailing Address
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Address Line | PO BOX 1164
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City | MAKAWAO
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State | HI
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Zip | 96768-1164
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Country | US
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Telephone | 808-298-6592
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Fax | 808-633-8527
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Authorized Official
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Title or Position | LCSW
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Name | SANDRA DIAZ
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Credential | LCSW
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Telephone | 808-298-6592
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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