Provider Demographics
NPI:1225258890
Name:KENT, DIANE CHRISTINE (SLP, BA)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:CHRISTINE
Last Name:KENT
Suffix:
Gender:F
Credentials:SLP, BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1440 N BLUE SAHUARO TRL
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85715-5248
Mailing Address - Country:US
Mailing Address - Phone:520-879-2074
Mailing Address - Fax:520-879-2088
Practice Address - Street 1:13801 E BENSON HWY
Practice Address - Street 2:
Practice Address - City:VAIL
Practice Address - State:AZ
Practice Address - Zip Code:85641-9074
Practice Address - Country:US
Practice Address - Phone:520-879-2074
Practice Address - Fax:520-879-2088
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLP085235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist