Provider Demographics
NPI:1669643615
Name:ROSSI, DYANA L (MA, CCC-A/SLP)
Entity Type:Individual
Prefix:MS
First Name:DYANA
Middle Name:L
Last Name:ROSSI
Suffix:
Gender:F
Credentials:MA, CCC-A/SLP
Other - Prefix:
Other - First Name:DYANA
Other - Middle Name:L
Other - Last Name:LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA, CCC-A/SLP
Mailing Address - Street 1:2167 KENSINGTON RD NE
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:OH
Mailing Address - Zip Code:44615-8626
Mailing Address - Country:US
Mailing Address - Phone:330-627-7651
Mailing Address - Fax:
Practice Address - Street 1:2167 KENSINGTON RD NE
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:OH
Practice Address - Zip Code:44615-8626
Practice Address - Country:US
Practice Address - Phone:330-627-7651
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA01391231H00000X
OHSP.11853235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist