Provider Demographics
NPI:1093237661
Name:HAVARD, DIANNA DELANE (MS, CC-SLP)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:DELANE
Last Name:HAVARD
Suffix:
Gender:F
Credentials:MS, CC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 S LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36104-4787
Mailing Address - Country:US
Mailing Address - Phone:334-293-7242
Mailing Address - Fax:334-293-7374
Practice Address - Street 1:602 SOUTH LAWRENCE STREET
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36104
Practice Address - Country:US
Practice Address - Phone:334-293-7242
Practice Address - Fax:334-293-7374
Is Sole Proprietor?:No
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3113235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist