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Individual
DIANA M PADILLA
Active
Individual
DIANA M PADILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC, EMT
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
373
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020402087
NATIONAL ATHLETIC TRAINERS' BOARD OF CERTIFICATION
—
01
—
0833
AZ STATE BOARD OF ATHLETIC TRAINING
AZ
01
—
AT-AT-10112912
OREGON HEALTH LICENSING
OR
Enumeration date
04/06/2006
Last updated
02/25/2010
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