Provider Demographics
NPI:1811134091
Name:DIAZ RIOS, NEFTALI (PHD)
Entity type:Individual
Prefix:DR
First Name:NEFTALI
Middle Name:
Last Name:DIAZ RIOS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:HC 11 BOX 12459
Mailing Address - Street 2:
Mailing Address - City:HUMACAO
Mailing Address - State:PR
Mailing Address - Zip Code:00791-9420
Mailing Address - Country:US
Mailing Address - Phone:787-361-5345
Mailing Address - Fax:
Practice Address - Street 1:HC. 11
Practice Address - Street 2:BOX 12459
Practice Address - City:HUMACAO
Practice Address - State:PR
Practice Address - Zip Code:00791-9420
Practice Address - Country:US
Practice Address - Phone:787-361-5345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-09
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR003101YA0400X
PR2097101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist