Bishop-Diaz, Kelly L

Bishop-Diaz, Kelly L is an sole proprietor health care provider with primary practice located at 2285 Star S Ave , Grand Forks ND 58201-3478. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bishop-Diaz, Kelly L can be contacted via phone (701) 330-8210.

Contact Information

Primary practice address
2285 Star S Ave Grand Forks ND 58201-3478
Phone: (701) 330-8210
Fax: (701) 330-8210
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 513 North Dakota
Behavioral Health & Social Service Providers / Clinical 103TC0700X 2616 Tennessee

Profile Details

NPI number 1891856860
LBN Legal business name Bishop-Diaz, Kelly L
Credentials PH.D.
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 13th, 2006
Last updated Sep 3rd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1891856860 NPPES
Tennessee Other 4107555 BCBS TN

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