Provider Demographics
NPI:1003338203
Name:DIEGUEZ CHAVEZ, ALIANETT
Entity Type:Individual
Prefix:
First Name:ALIANETT
Middle Name:
Last Name:DIEGUEZ CHAVEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 W 26 STREET
Mailing Address - Street 2:APT. 1
Mailing Address - City:HIALEAH
Mailing Address - State:FL
Mailing Address - Zip Code:33010
Mailing Address - Country:US
Mailing Address - Phone:786-479-8919
Mailing Address - Fax:
Practice Address - Street 1:1065 W 26TH ST APT 1
Practice Address - Street 2:
Practice Address - City:HIALEAH
Practice Address - State:FL
Practice Address - Zip Code:33010-1126
Practice Address - Country:US
Practice Address - Phone:786-479-8919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-10
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician