Provider Demographics
NPI:1346429891
Name:EPPERLY, DIANE ELIZABETH (CCC/SLP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:ELIZABETH
Last Name:EPPERLY
Suffix:
Gender:F
Credentials:CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 SCHOOL STREET
Mailing Address - Street 2:OAK HILL ELEMENTARY
Mailing Address - City:OAK HILL
Mailing Address - State:WV
Mailing Address - Zip Code:25901
Mailing Address - Country:US
Mailing Address - Phone:304-469-4541
Mailing Address - Fax:304-469-4310
Practice Address - Street 1:140 SCHOOL STREET
Practice Address - Street 2:OAK HILL ELEMENTARY
Practice Address - City:OAK HILL
Practice Address - State:WV
Practice Address - Zip Code:25901
Practice Address - Country:US
Practice Address - Phone:304-469-4541
Practice Address - Fax:304-469-4310
Is Sole Proprietor?:No
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVSLP-0149235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist