| NPI | 1407365091 |
|---|---|
| Former Name | JENNIFER DIAZ |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 103T00000X Psychologist |
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2017-09-26 |
| Last Update Date | 2025-07-25 |