Provider Demographics
NPI:1528439726
Name:SAYRE, BERTHA DIANA DEL RIO (PSYD)
Entity type:Individual
Prefix:DR
First Name:BERTHA
Middle Name:DIANA DEL RIO
Last Name:SAYRE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3411 CREST NOCHE DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78261-2857
Mailing Address - Country:US
Mailing Address - Phone:512-619-4657
Mailing Address - Fax:
Practice Address - Street 1:3411 CREST NOCHE DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78261-2857
Practice Address - Country:US
Practice Address - Phone:512-619-4657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-13
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT048-0000853103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical