Provider Demographics
NPI:1144455205
Name:VELEZ, DIANA (PHD)
Entity type:Individual
Prefix:DR
First Name:DIANA
Middle Name:
Last Name:VELEZ
Suffix:
Gender:F
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:CONDOMINIO COSTA MARINA I APT 9A
Mailing Address - Street 2:AVE. GALICIA FINAL
Mailing Address - City:CAROLINA
Mailing Address - State:PR
Mailing Address - Zip Code:00983
Mailing Address - Country:US
Mailing Address - Phone:787-644-0156
Mailing Address - Fax:787-757-4078
Practice Address - Street 1:1607 AVE PONCE DE LEON
Practice Address - Street 2:COBIANS PLAZA SUITE 109
Practice Address - City:SANTURCE
Practice Address - State:PR
Practice Address - Zip Code:00909-1820
Practice Address - Country:US
Practice Address - Phone:787-644-0156
Practice Address - Fax:787-757-4078
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR2920103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical