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NPI Code Detail

MEDICARE: ANA MAYARI DIAZ LMSW

MEDICARE: ANA MAYARI DIAZ LMSW
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
11041C0700XClinical Social Worker6801092902MI

General Provider Information

NPI Number : 1396082889
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANA MAYARI DIAZ LMSW
Provider Business Mailing Address
First Line : 2222 W GRAND RIVER AVE STE A
Second Line :
City : OKEMOS
State : MI
Zip : 48864-1604
Country : US
Telephone Number : 248-247-2033
Fax Number :
Provider Business Practice Location Address
First Line : 2222 W GRAND RIVER AVE STE A
Second Line :
City : OKEMOS
State : MI
Zip : 48864-1604
Country : US
Telephone Number : 248-247-2033
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/03/2013
Last Update Date : 12/18/2023

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Directions to “ ANA MAYARI DIAZ LMSW” Practice Location

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