Provider Demographics
NPI:1235344870
Name:SLAVIERO, DIANA L (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANA
Middle Name:L
Last Name:SLAVIERO
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 1:75 EXECUTIVE DR
Mailing Address - Street 2:SUITE 429
Mailing Address - City:AURORA
Mailing Address - State:IL
Mailing Address - Zip Code:60504-8137
Mailing Address - Country:US
Mailing Address - Phone:630-405-8633
Mailing Address - Fax:630-225-5322
Practice Address - Street 1:75 EXECUTIVE DR
Practice Address - Street 2:SUITE 429
Practice Address - City:AURORA
Practice Address - State:IL
Practice Address - Zip Code:60504-8137
Practice Address - Country:US
Practice Address - Phone:630-405-8633
Practice Address - Fax:630-225-5322
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071007516103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical