Provider Demographics
NPI:1962125997
Name:DIAZ MARTINEZ, ALMA BIRIDIANA
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:BIRIDIANA
Last Name:DIAZ MARTINEZ
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 1:5838 N ARTESIAN AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60659-5081
Mailing Address - Country:US
Mailing Address - Phone:773-546-8745
Mailing Address - Fax:
Practice Address - Street 1:5838 N ARTESIAN AVE APT 2
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-5081
Practice Address - Country:US
Practice Address - Phone:773-546-8745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician