Provider Demographics
NPI:1215412705
Name:ZEIDENSTIEN, DYANA K
Entity Type:Individual
Prefix:
First Name:DYANA
Middle Name:K
Last Name:ZEIDENSTIEN
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 1:1652 OLD HENDERSON RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3618
Mailing Address - Country:US
Mailing Address - Phone:614-459-6901
Mailing Address - Fax:
Practice Address - Street 1:1652 OLD HENDERSON RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3618
Practice Address - Country:US
Practice Address - Phone:614-459-6901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-01
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH235Z00000X
OHSP.13697235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist