Provider Demographics
NPI:1922410760
Name:DIAZ, KATHLEEN SUSAN (MS, LCGC)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:SUSAN
Last Name:DIAZ
Suffix:
Gender:F
Credentials:MS, LCGC
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:SUSAN
Other - Last Name:MAHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, LCGC
Mailing Address - Street 1:4815 LIBERTY AVE STE GR59
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15224-2156
Mailing Address - Country:US
Mailing Address - Phone:412-578-3951
Mailing Address - Fax:412-578-1587
Practice Address - Street 1:4815 LIBERTY AVE STE GR59
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15224-2156
Practice Address - Country:US
Practice Address - Phone:412-578-3951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2021-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS