Individual ProviderShanelle DiazCounselorBehavioral Health & Social Service ProvidersPractice Address1022 Martha Blvd, Atco, NJ 08004-1451(856) 719-6905(609) 267-5928PECOS EnrollmentBased on the most recent information from CMS, provider Shanelle Diaz does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1538577721Provider TypeIndividualFull NameDiaz, ShanelleTitleMrs.GenderFemaleSole ProprietorNoEnumeration Date7/31/2014Last Updated7/31/2014Contact InformationPractice LocationPractice Address1022 Martha Blvd, Atco, NJ 08004-1451Phone(856) 719-6905Fax(856) 719-6907Mailing LocationMailing Address770 Woodlane Rd, Mt. Holly, NJ 08060Phone(609) 267-5928FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode101YM0800XPrimaryDescriptionCounselorBehavioral Health & Social Service ProvidersLicenseUnlisted Issuer