Provider Demographics
NPI:1770729147
Name:BYAS-DIAZ, DORIS C (LMFT)
Entity type:Individual
Prefix:
First Name:DORIS
Middle Name:C
Last Name:BYAS-DIAZ
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 TIEMAN CIR
Mailing Address - Street 2:
Mailing Address - City:DELANCO
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-5050
Mailing Address - Country:US
Mailing Address - Phone:412-409-4857
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:412-409-4857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-06
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
PAMF000965101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health