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General NPI Number Information
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NPI Number | 1215572037
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Entity Type | Organization
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Legal Business Name | DIANA NOMIKOS KATZ PA
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Dates
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Enumeration Date | 11/15/2019
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 2400 E COMMERCIAL BLVD 723
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City | FT LAUDERDALE
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State | FL
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Zip | 33308-4131
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Country | US
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Telephone | 954-449-5232
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Fax | 954-840-8254
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Provider Business Mailing Address
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Address Line | 4832 NW 20TH PL
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City | COCONUT CREEK
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State | FL
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Zip | 33063-7751
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Country | US
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Telephone | 954-224-0555
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Fax | 954-840-8254
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Authorized Official
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Title or Position | PSYCHOLOGIST/OWNER
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Name | MISS DIANA NOMIKOS KATZ
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Credential | PSY.D
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Telephone | 954-449-5232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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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 |
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License Number State |
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