Provider Demographics
NPI:1720827066
Name:DIAZ SOLIS, TAGNY ISABEL
Entity type:Individual
Prefix:
First Name:TAGNY
Middle Name:ISABEL
Last Name:DIAZ SOLIS
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 1:4411 TRIUMPH DR SW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-2707
Mailing Address - Country:US
Mailing Address - Phone:704-490-6166
Mailing Address - Fax:
Practice Address - Street 1:4411 TRIUMPH DR SW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-2707
Practice Address - Country:US
Practice Address - Phone:704-491-6166
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-24
Last Update Date:2024-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach