Provider Demographics
NPI:1669141800
Name:DIAZ GUERRERO, MARIA G (PLMHP PLADC)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:G
Last Name:DIAZ GUERRERO
Suffix:
Gender:F
Credentials:PLMHP PLADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 BUFFALO BEND PO BOX 797
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NE
Mailing Address - Zip Code:68850
Mailing Address - Country:US
Mailing Address - Phone:380-324-6386
Mailing Address - Fax:308-324-4026
Practice Address - Street 1:1103 BUFFALO BEND 797
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NE
Practice Address - Zip Code:68850
Practice Address - Country:US
Practice Address - Phone:308-324-6386
Practice Address - Fax:308-324-4026
Is Sole Proprietor?:No
Enumeration Date:2021-09-10
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12723101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health