Provider Demographics
NPI:1205901170
Name:DIAZ-MARTINEZ, ANGELICA M (PSYD)
Entity type:Individual
Prefix:DR
First Name:ANGELICA
Middle Name:M
Last Name:DIAZ-MARTINEZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 307
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-0307
Mailing Address - Country:US
Mailing Address - Phone:732-735-7408
Mailing Address - Fax:
Practice Address - Street 1:112 TOWN CENTER
Practice Address - Street 2:DM PSYCHOLOGICAL CONSULTANTS LLC
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059
Practice Address - Country:US
Practice Address - Phone:732-735-7408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00388500103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical