Individual
EMILY R DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
738 S BRIDGEWAY PL STE 150, EAGLE, ID 83616-6953
(208) 210-4442
Mailing address
738 S BRIDGEWAY PL STE 150, EAGLE, ID 83616-6953
(208) 210-4442
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
ID
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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