Individual
CYNTHIA D DIAZ DE LEON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
7201 BROADWAY, SUITE 218, SAN ANTONIO, TX 78209-3773
(210) 930-8988
(210) 930-8986
Mailing address
7201 BROADWAY, SUITE 218, SAN ANTONIO, TX 78209-3773
(210) 930-8988
(210) 930-8986
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
25303
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0023CE
BCBS
TX
Enumeration date
02/13/2007
Last updated
07/08/2007
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