Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 102L00000X | Psychologist | 004108 | PR |
Y | 103T00000X | Psychologist | 004108 | PR |
N | 103TB0200X | Cognitive & Behavioral Psychologist | 004108 | PR |
N | 103TC1900X | Counseling Psychologist | 004108 | PR |
N | 103TH0004X | Health Psychologist | 004108 | PR |
N | 103TH0100X | Health Service | 004108 | PR |
NPI | 1669846366 |
---|---|
Provider Name | Hilda Diaz |
First Address | Dorado, PR 00646-4714 |
Second Address | Dorado, PR 00646-4714 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/11/2015 |
Last Update Date | 18/11/2015 |