Provider Demographics
NPI:1598966376
Name:VERDUZCO, DIANA T (M ED, LPC)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:T
Last Name:VERDUZCO
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 MCKEE DR
Mailing Address - Street 2:
Mailing Address - City:EDINBURG
Mailing Address - State:TX
Mailing Address - Zip Code:78539-6031
Mailing Address - Country:US
Mailing Address - Phone:956-380-0020
Mailing Address - Fax:956-664-1623
Practice Address - Street 1:210 W NOLANA ST
Practice Address - Street 2:SUITE B
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-2582
Practice Address - Country:US
Practice Address - Phone:956-664-1600
Practice Address - Fax:956-664-1623
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-30
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6052101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional