Provider Demographics
NPI:1184865065
Name:SLONIM, DIANE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:L
Last Name:SLONIM
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:517 MARTLING AVE
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4718
Mailing Address - Country:US
Mailing Address - Phone:914-767-0488
Mailing Address - Fax:914-767-0488
Practice Address - Street 1:517 MARTLING AVE
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4718
Practice Address - Country:US
Practice Address - Phone:914-767-0488
Practice Address - Fax:914-767-0488
Is Sole Proprietor?:No
Enumeration Date:2009-03-23
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009785-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist