Provider Demographics
NPI:1316650245
Name:SENZIG, DIANA (MA)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:
Last Name:SENZIG
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MAYA
Other - Middle Name:
Other - Last Name:SENZIG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:106 E BASELINE RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-2403
Mailing Address - Country:US
Mailing Address - Phone:970-460-8997
Mailing Address - Fax:
Practice Address - Street 1:106 E BASELINE RD
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-2403
Practice Address - Country:US
Practice Address - Phone:970-460-8997
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2023-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0018477101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health