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Individual
MRS. GISSA ELENA DIAZ
Active
Individual
MRS. GISSA ELENA DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS. CCC/SLP
Taxonomy
Speciality
Code
Description
License number
State
222Q00000X
Developmental Therapist
—
—
235Z00000X
Speech-Language Pathologist
Primary
SA7413
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
811998800
—
FL
05
—
887943500
—
FL
01
—
S9291
BC/BS OF FLORIDA #
FL
Enumeration date
10/11/2006
Last updated
08/11/2011
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