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NPI Code Detail

MEDICARE: EDUARDO DIAZ

MEDICARE:   EDUARDO  DIAZ
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
1106H00000XMarriage & Family TherapistMI4196NV

General Provider Information

NPI Number : 1063128429
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDUARDO DIAZ
Provider Business Mailing Address
First Line : 6655 W SAHARA AVE STE C203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-0850
Country : US
Telephone Number : 702-900-2784
Fax Number :
Provider Business Practice Location Address
First Line : 6655 W SAHARA AVE STE C203
Second Line :
City : LAS VEGAS
State : NV
Zip : 89146-0850
Country : US
Telephone Number : 702-900-2784
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/27/2023
Last Update Date : 01/27/2023

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Directions to “ EDUARDO DIAZ ” Practice Location

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