Provider Demographics
NPI:1003071549
Name:SANCHEZ, DIANA IRIS (LPC)
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:IRIS
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 S 222ND DR
Mailing Address - Street 2:
Mailing Address - City:BUCKEYE
Mailing Address - State:AZ
Mailing Address - Zip Code:85326-6280
Mailing Address - Country:US
Mailing Address - Phone:623-556-6038
Mailing Address - Fax:
Practice Address - Street 1:319 N LITCHFIELD RD STE 105
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85338-1256
Practice Address - Country:US
Practice Address - Phone:623-556-6038
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-24
Last Update Date:2022-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-10737101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ742562293Medicaid
AZ864555Medicaid