Provider Demographics
NPI:1174969042
Name:DIAS, ISABELLA (MS IN EDUCATION & MA)
Entity type:Individual
Prefix:MRS
First Name:ISABELLA
Middle Name:
Last Name:DIAS
Suffix:
Gender:F
Credentials:MS IN EDUCATION & MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:37-55 84TH ST, APT. #2
Mailing Address - Street 2:
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372
Mailing Address - Country:US
Mailing Address - Phone:718-429-3971
Mailing Address - Fax:
Practice Address - Street 1:37-55 84TH ST, APT. #2
Practice Address - Street 2:
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372
Practice Address - Country:US
Practice Address - Phone:718-429-3971
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-17
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst