Provider Demographics
NPI:1831645225
Name:DELGADO, DIANA MARITZA
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:MARITZA
Last Name:DELGADO
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 1:16175 GOLF CLUB RD APT 308
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:FL
Mailing Address - Zip Code:33326-1652
Mailing Address - Country:US
Mailing Address - Phone:954-298-7568
Mailing Address - Fax:
Practice Address - Street 1:16175 GOLF CLUB RD APT 308
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:FL
Practice Address - Zip Code:33326-1652
Practice Address - Country:US
Practice Address - Phone:954-298-7568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-26
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist