Individual
MISS DIANA JOSEFINA CHAVEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
23450 VIA COCONUT PT, ESTERO, FL 34135-1877
(239) 468-0150
(239) 343-4056
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 468-0150
(239) 343-4056
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
PY10636
FL
103TC0700X
Clinical Psychologist
PSY20505
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
105559600
—
FL
Enumeration date
08/12/2008
Last updated
06/20/2024
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