| Doctor Name: | SUCELLY MELISSA DIAZ ERAZO |
| NPI Number: | 1023486438 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 501 El Rancho Dr Spc 88 Sparks, NV - 894314117 |
| Business Phone Number: | 7752236530 |
| Business Fax Number: | |
| Mailing Address: | 501 El Rancho Dr Spc 88, SPARKS |
| State: | NV |
| Postal Code: | 894314117 |
| Phone Number: | 7752236530 |
| Fax Number: | |
| NPI Enumeration Date: | 09/02/2015 |
| NPI Last Update Date: | 09/02/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |