MEDICARE: KATIA DIAZ-ALVAREZ

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1548884042
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATIA DIAZ-ALVAREZ

Provider Business Mailing Address
First Line	:	2866 VIA FIRENZE
Second Line	:
City	:	HENDERSON
State	:	NV
Zip	:	89044-0575
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2110 E FLAMINGO RD STE 205
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89119-5192
Country	:	US
Telephone Number	:	702-620-5105
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2020
Last Update Date	:	06/01/2020

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Directions to “ KATIA DIAZ-ALVAREZ ” Practice Location

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