Individual
MRS. AMBAR E DIAZ DEL VALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS
Contact information
Practice address
CALLE DUFRESNE #19 SUITE 1, HUMACAO, PR 00791
(787) 341-8626
Mailing address
PO BOX 763, YABUCOA, PR 00767-0763
(787) 341-8626
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103T00000X
Psychologist
Primary
5362
PR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018214
—
MS
Enumeration date
05/28/2008
Last updated
03/24/2015
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