Provider Demographics
NPI:1558746925
Name:PLOWGIAN, CLAIRE DIANE DIETER
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:DIANE DIETER
Last Name:PLOWGIAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:868 RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47803-2087
Mailing Address - Country:US
Mailing Address - Phone:847-508-6789
Mailing Address - Fax:
Practice Address - Street 1:450 8TH AVE
Practice Address - Street 2:UNION PEDIATRIC THERAPY
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47804-4030
Practice Address - Country:US
Practice Address - Phone:812-238-7171
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-27
Last Update Date:2015-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN22005949A235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist