Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 106S00000X | Behavior Technician |
NPI | 1003406638 |
---|---|
Provider Name | Emileigh Diaz |
First Address | Colorado Springs, CO 80909-1696 |
Second Address | Colorado Springs, CO 80909-1696 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/01/2021 |
Last Update Date | 18/01/2021 |