Provider Demographics
NPI:1376253385
Name:DORIS C BYAS-DIAZ LLC
Entity Type:Organization
Organization Name:DORIS C BYAS-DIAZ LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DORIS
Authorized Official - Middle Name:C
Authorized Official - Last Name:BYAS-DIAZ
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:267-348-9916
Mailing Address - Street 1:123 E WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19120-4429
Mailing Address - Country:US
Mailing Address - Phone:267-348-9916
Mailing Address - Fax:
Practice Address - Street 1:121 E WYOMING AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19120-4429
Practice Address - Country:US
Practice Address - Phone:267-348-9916
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-30
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty