=====================================================
General NPI Number Information
=====================================================
NPI Number | 1689141152
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VIOLETA DIAZ LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/01/2018
-----------------------------------------------------
Last Update Date | 03/10/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 705 N BENTSEN PALM DR, SUITE 2
-----------------------------------------------------
City | PALMVIEW
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572-2980
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-289-2951
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 705 N BENTSEN PALM DR, SUITE 2
-----------------------------------------------------
City | PALMVIEW
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78572
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-289-3951
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | 77567
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------