Individual
KRYSTAL DIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BS/CPSS
Contact information
Practice address
2007 E QUAIL RUN RD STE 1, EMMETT, ID 83617-5059
(208) 365-5445
Mailing address
307 N DE CLARK AVE, EMMETT, ID 83617-3153
(208) 365-5445
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
ID
174400000X
Specialist
—
ID
175T00000X
Peer Specialist
Primary
—
ID
Other
Enumeration date
11/19/2025
Last updated
11/19/2025
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