Individual
MS. ALEXA MARIE DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
635 EAST BASELINE ROAD, PHOENIX, AZ 85042-6551
(602) 243-7277
(602) 243-1235
Mailing address
2702 NORTH 3RD STREET, 4020, PHOENIX, AZ 85004-4608
(602) 323-3407
(602) 323-3496
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
—
—
133V00000X
Registered Dietitian
Primary
86002413
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
701269
—
AZ
Enumeration date
12/02/2011
Last updated
10/12/2012
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