Provider Demographics
NPI:1689935637
Name:DIANNE D. STEENSLAND, LLC
Entity Type:Organization
Organization Name:DIANNE D. STEENSLAND, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DIANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:STEENSLAND
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:334-699-8878
Mailing Address - Street 1:3124 W MAIN ST
Mailing Address - Street 2:SUITE 14
Mailing Address - City:DOTHAN
Mailing Address - State:AL
Mailing Address - Zip Code:36305-1146
Mailing Address - Country:US
Mailing Address - Phone:334-699-8878
Mailing Address - Fax:334-699-5175
Practice Address - Street 1:3124 W MAIN ST
Practice Address - Street 2:SUITE 14
Practice Address - City:DOTHAN
Practice Address - State:AL
Practice Address - Zip Code:36305-1146
Practice Address - Country:US
Practice Address - Phone:334-699-8878
Practice Address - Fax:334-699-5175
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL0109235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL137752Medicaid