Organization
CARMEN M DIAZ PHD
Active
Organization
CARMEN M DIAZ PHD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KARLA CHAVEZ (BUSINESS MANAGER)
(575) 522-5802
Entity
Organization
Contact information
Practice address
2507 N TELSHOR BLVD, STE A4, LAS CRUCES, NM 88011-8285
(575) 522-5802
Mailing address
2507 N TELSHOR BLVD, STE A4, LAS CRUCES, NM 88011-8285
(575) 522-5802
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00679577
—
NM
05
—
62125729
—
NM
Enumeration date
08/01/2014
Last updated
12/02/2014
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