Provider Demographics
NPI:1275165235
Name:ALBERT, DIANE NICOLE (MS, SLP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:NICOLE
Last Name:ALBERT
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:766 GARRET RD
Mailing Address - Street 2:
Mailing Address - City:MILL SPRING
Mailing Address - State:NC
Mailing Address - Zip Code:28756-5801
Mailing Address - Country:US
Mailing Address - Phone:530-575-5775
Mailing Address - Fax:
Practice Address - Street 1:766 GARRET RD
Practice Address - Street 2:
Practice Address - City:MILL SPRING
Practice Address - State:NC
Practice Address - Zip Code:28756-5801
Practice Address - Country:US
Practice Address - Phone:530-575-5775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-07
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14938235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist