Provider Demographics
NPI:1568618726
Name:ALANIZ, DIANNA CAROL (OT)
Entity Type:Individual
Prefix:
First Name:DIANNA
Middle Name:CAROL
Last Name:ALANIZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1073 E BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-3502
Mailing Address - Country:US
Mailing Address - Phone:479-381-3709
Mailing Address - Fax:
Practice Address - Street 1:201 S GILES AVE
Practice Address - Street 2:
Practice Address - City:GENTRY
Practice Address - State:AR
Practice Address - Zip Code:72734-9320
Practice Address - Country:US
Practice Address - Phone:479-736-8562
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-07
Last Update Date:2008-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AROTR874225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist