Provider Demographics
NPI:1275033318
Name:DIAZ, ESTER NATHALY
Entity Type:Individual
Prefix:MS
First Name:ESTER
Middle Name:NATHALY
Last Name:DIAZ
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 1:5144 RANDOLPH ST
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4925
Mailing Address - Country:US
Mailing Address - Phone:504-430-4938
Mailing Address - Fax:
Practice Address - Street 1:5144 RANDOLPH ST
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4925
Practice Address - Country:US
Practice Address - Phone:504-430-4938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-02-15
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health