Provider Demographics
NPI:1164979167
Name:DEUKMAJIAN, DINA
Entity Type:Individual
Prefix:MISS
First Name:DINA
Middle Name:
Last Name:DEUKMAJIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 PIONEER DR UNIT 1201E
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-2773
Mailing Address - Country:US
Mailing Address - Phone:818-915-5791
Mailing Address - Fax:
Practice Address - Street 1:343 PIONEER DR UNIT 1201E
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-2773
Practice Address - Country:US
Practice Address - Phone:818-915-5791
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-07
Last Update Date:2016-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22882355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant