Diaz, Sandra Hall

Diaz, Sandra Hall is an sole proprietor health care provider with primary practice located at 310 W. Porter Ave , Ocean Springs MS 39564. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Diaz, Sandra Hall can be contacted via phone (228) 872-2011.

Contact Information

Primary practice address
310 W. Porter Ave Ocean Springs MS 39564
Phone: (228) 872-2011
Fax: (228) 872-3791
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X C1885 Mississippi

Profile Details

NPI number 1801977921
LBN Legal business name Diaz, Sandra Hall
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2006
Last updated May 6th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1801977921 NPPES
Mississippi MEDICAID 0118148
Mississippi Other 62-51970
Mississippi Other SWL-3703000
Mississippi Other C1885

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