Provider Demographics
NPI:1700341005
Name:STEINER, DIANA (MA, LAC, CCTP)
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:STEINER
Suffix:
Gender:F
Credentials:MA, LAC, CCTP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28425 N BLACK CANYON HWY UNIT 3039
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-7618
Mailing Address - Country:US
Mailing Address - Phone:480-250-2642
Mailing Address - Fax:
Practice Address - Street 1:18301 N 79TH AVE STE F168
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-6045
Practice Address - Country:US
Practice Address - Phone:602-633-2246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-31
Last Update Date:2019-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLAC-17678101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional