Provider Demographics
NPI:1457856197
Name:DYAKIV, NADIA ESTRELLA (PT)
Entity Type:Individual
Prefix:MRS
First Name:NADIA
Middle Name:ESTRELLA
Last Name:DYAKIV
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:NADIA
Other - Middle Name:ESTRELLA
Other - Last Name:BABBITT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:8123 FORGET ME NOT ST
Mailing Address - Street 2:
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85365-7884
Mailing Address - Country:US
Mailing Address - Phone:928-261-0518
Mailing Address - Fax:
Practice Address - Street 1:3970 W 24TH ST STE 108
Practice Address - Street 2:
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85364-9257
Practice Address - Country:US
Practice Address - Phone:928-783-0555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13692225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist