Provider Demographics
NPI:1619130028
Name:SLAVIN, DIANE CHARLOTTE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DIANE
Middle Name:CHARLOTTE
Last Name:SLAVIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 NEVINWOOD PLACE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON STATION
Mailing Address - State:NY
Mailing Address - Zip Code:11746-3528
Mailing Address - Country:US
Mailing Address - Phone:631-385-8314
Mailing Address - Fax:
Practice Address - Street 1:22 NEVINWOOD PLACE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON STATION
Practice Address - State:NY
Practice Address - Zip Code:11746-3528
Practice Address - Country:US
Practice Address - Phone:631-385-8314
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2024-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0002011235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist