Provider Demographics
NPI:1598902827
Name:MORAN, DIANNE (SLP)
Entity Type:Individual
Prefix:MISS
First Name:DIANNE
Middle Name:
Last Name:MORAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TALMADGE RD
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-6100
Mailing Address - Country:US
Mailing Address - Phone:845-225-3837
Mailing Address - Fax:
Practice Address - Street 1:5 TALMADGE RD
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:NY
Practice Address - Zip Code:10512-6100
Practice Address - Country:US
Practice Address - Phone:845-225-3837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2009-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0171481235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist