Most Relevant Information
Provider Data
| NPI Number: | 1003560426 |
| Provider Name: | DIANA LUCERO |
| Entity Type: | Individual |
| Taxonomy Code: | 101YA0400X |
| Specialty: | Counselor |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/04/2022 |
| Last Updated: | 02/04/2022 |
Provider Practice Location
7010 E BOGARD RD BLDG 1
WASILLA
AK
996544711
Practice Location Phone/Fax
| Phone: | 9077464748 |
| Fax: | 9077464750 |
Provider Mailing Location
PO BOX 876741
WASILLA
AK
996876741
Provider Mailing Phone/Fax
| Phone: | 9073734732 |
| Fax: | 9077464749 |