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Individual

DR. DIANA MARCELA CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D.

Contact information

Practice address
31 COVERT AVE # 1035, FLORAL PARK, NY 11001-3216
(818) 263-2267
Mailing address
31 COVERT AVE # 1035, FLORAL PARK, NY 11001-3216

Taxonomy

Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1063796696
INDIVIDUAL
CA
Enumeration date
09/30/2011
Last updated
03/25/2025
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