Provider Demographics
NPI:1568429108
Name:ROBEY, DIANE JOHNSON (MS CCC SLP)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:JOHNSON
Last Name:ROBEY
Suffix:
Gender:F
Credentials:MS CCC SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 N MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802
Mailing Address - Country:US
Mailing Address - Phone:540-434-1941
Mailing Address - Fax:540-433-8277
Practice Address - Street 1:463 E WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802
Practice Address - Country:US
Practice Address - Phone:540-433-3100
Practice Address - Fax:540-432-6989
Is Sole Proprietor?:No
Enumeration Date:2006-04-27
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2202000919235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004978552Medicaid