Provider Demographics
NPI:1841482536
Name:INIGUEZ-CORLEW, DIANA (LPC)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:INIGUEZ-CORLEW
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 1:4300 E PIMA ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-3432
Mailing Address - Country:US
Mailing Address - Phone:520-272-3888
Mailing Address - Fax:
Practice Address - Street 1:380 E FORT LOWELL RD
Practice Address - Street 2:SUITE 201
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85705-3985
Practice Address - Country:US
Practice Address - Phone:520-272-3888
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-16
Last Update Date:2008-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLPC-12364101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional