Provider Demographics
NPI:1083858385
Name:KIAI, DIANE LEAH (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:LEAH
Last Name:KIAI
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:67-17 FRESH MEADOW LANE
Mailing Address - Street 2:
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11365-3418
Mailing Address - Country:US
Mailing Address - Phone:718-939-1530
Mailing Address - Fax:
Practice Address - Street 1:1133 WESTCHESTER AVE STE N-230
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10604-3522
Practice Address - Country:US
Practice Address - Phone:212-564-2350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-30
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018574235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist