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General NPI Number Information
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NPI Number | 1194615500
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Entity Type | Individual
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Provider Name | DIANA EUCEDA
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Gender | Female
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Dates
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Enumeration Date | 07/07/2025
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Last Update Date | 07/07/2025
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Provider Practice Location Address
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Address Line | 1190 WINTERSON RD STE 160
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City | LINTHICUM
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State | MD
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Zip | 21090-2245
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Country | US
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Telephone | 410-684-3806
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Fax |
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Provider Business Mailing Address
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Address Line | 14 20TH AVE
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City | BAY SHORE
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State | NY
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Zip | 11706-3111
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Country | US
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Telephone | 631-452-4895
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | A01077
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License Number State | MD
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