Provider Demographics
NPI:1730824921
Name:DIAZ, FAITH MARCI (CBT)
Entity type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:MARCI
Last Name:DIAZ
Suffix:
Gender:F
Credentials:CBT
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:9911 CRANBERRY LN NW APT 104
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8071
Mailing Address - Country:US
Mailing Address - Phone:316-208-6064
Mailing Address - Fax:
Practice Address - Street 1:4301 S TACOMA WAY STE 505
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-4522
Practice Address - Country:US
Practice Address - Phone:253-292-4354
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-02
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician