Doctor Name: | DR. TANIA DIAZ |
NPI Number: | 1053548875 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PSYD |
License Number: | PY6296 |
Business Practice Address: | 6625 Miami Lakes Dr Suite 328 Miami Lakes, FL - 330142708 |
Business Phone Number: | 3057798565 |
Business Fax Number: | 3057798564 |
Mailing Address: | 6625 Miami Lakes Dr, Suite 328 MIAMI LAKES |
State: | FL |
Postal Code: | 330142708 |
Phone Number: | 3057798565 |
Fax Number: | 3057798564 |
NPI Enumeration Date: | 06/18/2009 |
NPI Last Update Date: | 06/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 103TC0700X |
License Number: | PY6296 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Psychologist |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: |