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General NPI Number Information
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NPI Number | 1558750208
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Entity Type | Individual
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Provider Name | DIANA CAROLINA REYES C.P.M, L.M
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Gender | Female
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Dates
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Enumeration Date | 01/19/2015
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Last Update Date | 01/19/2015
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Provider Practice Location Address
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Address Line | 3820 S 3RD AVE
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City | TUCSON
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State | AZ
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Zip | 85714-1522
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Country | US
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Telephone | 505-489-1482
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Fax |
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Provider Business Mailing Address
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Address Line | 3820 S 3RD AVE
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City | TUCSON
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State | AZ
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Zip | 85714-1522
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Country | US
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Telephone | 505-489-1482
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | LM193
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License Number State | AZ
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