Individual
MRS. NICHOLE B DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CSW, BT
Contact information
Practice address
500 UNSER BLVD SE STE 103, RIO RANCHO, NM 87124-4660
(505) 623-9814
Mailing address
9005 EL OJITO CT NW, ALBUQUERQUE, NM 87114-5968
(505) 322-0237
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
171M00000X
Case Manager/Care Coordinator
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N0015917
—
NM
Enumeration date
07/23/2024
Last updated
08/08/2025
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