Provider Demographics
NPI:1497065064
Name:JENNINGS, DIANNA L (SPEECH AND LANGUAGE)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:L
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:SPEECH AND LANGUAGE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E ADRIATIC ST # 7
Mailing Address - Street 2:
Mailing Address - City:KINGSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64061-9202
Mailing Address - Country:US
Mailing Address - Phone:816-597-3422
Mailing Address - Fax:816-597-3702
Practice Address - Street 1:101 E ADRIATIC ST # 7
Practice Address - Street 2:
Practice Address - City:KINGSVILLE
Practice Address - State:MO
Practice Address - Zip Code:64061-9202
Practice Address - Country:US
Practice Address - Phone:816-597-3422
Practice Address - Fax:816-597-3702
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2010-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist