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Individual

BRITTANY NICOLE DIAZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
21045 N 9TH PL STE 204, PHOENIX, AZ 85024-5635
(602) 726-2300
Mailing address
2009 MERMAID DR., EL PASO, TX 79936
(915) 637-1676

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
009441
AZ
225X00000X
Occupational Therapist
117679
TX
235Z00000X
Speech-Language Pathologist
37126
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149984001
TX
05
189296
AZ
05
207164901
TX
Enumeration date
09/19/2012
Last updated
05/28/2024
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