Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101Y00000X | Counselor |
NPI | 1003151192 |
---|---|
Provider Name | Mr. Uriel Diaz-Chavez |
First Address | Reno, NV 89503-4923 |
Second Address | Reno, NV 89503-4923 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2012 |
Last Update Date | 30/11/2012 |