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General NPI Number Information
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NPI Number | 1710341086
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Entity Type | Individual
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Provider Name | AMIE MICHELLE DIAZ-PAZ LPC
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Gender | Female
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 100 SHOCKOE SLIP FL 2
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City | RICHMOND
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State | VA
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Zip | 23219-4100
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Country | US
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Telephone | 800-997-6196
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Fax | 833-523-9924
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Provider Business Mailing Address
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Address Line | 1 CALIFORNIA ST STE 2300
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City | SAN FRANCISCO
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State | CA
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Zip | 94111-5424
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Country | US
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Telephone | 800-997-6196
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Fax | 833-523-9924
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701006575
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License Number State | VA
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