Provider Information for 1518544865
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ROXANNE ROYBAL DE DIAZ MA, LPC NCC
Sex: Female
NPI: 1518544865
Last Updated: 2023-09-27
Certification Date: 2023-09-27
Certification Date: 2023-09-27
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1518544865 | ||||||||
| Enumeration Date | 2021-03-24 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 933 PINE LOG RD # 1190 AIKEN, SC 29803-7330 United States Phone: 803-265-2184 | Fax: | ||||||||
| Primary Practice Address | SEEADLERWEG 6 VIENNA, VIENNA A1220 Austria Phone: 803-265-2184 | Fax: | ||||||||
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