Provider Demographics
NPI:1184912545
Name:DIEZ, AILEEN (LMHC)
Entity type:Individual
Prefix:MRS
First Name:AILEEN
Middle Name:
Last Name:DIEZ
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7900 OAK LN OFC 437
Mailing Address - Street 2:
Mailing Address - City:MIAMI LAKES
Mailing Address - State:FL
Mailing Address - Zip Code:33016-5888
Mailing Address - Country:US
Mailing Address - Phone:305-688-2826
Mailing Address - Fax:786-456-5001
Practice Address - Street 1:7900 OAK LN OFC 437
Practice Address - Street 2:
Practice Address - City:MIAMI LAKES
Practice Address - State:FL
Practice Address - Zip Code:33016-5888
Practice Address - Country:US
Practice Address - Phone:305-688-2826
Practice Address - Fax:786-456-5001
Is Sole Proprietor?:No
Enumeration Date:2011-07-19
Last Update Date:2021-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9494101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health