Provider Demographics
NPI:1821251679
Name:HOLAN, DIANA L
Entity Type:Individual
Prefix:
First Name:DIANA
Middle Name:L
Last Name:HOLAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9097 E DESERT COVE
Mailing Address - Street 2:STE 260
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260
Mailing Address - Country:US
Mailing Address - Phone:480-614-5406
Mailing Address - Fax:480-889-0586
Practice Address - Street 1:1775 W SAINT MARYS RD
Practice Address - Street 2:STE. 211
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85745-2696
Practice Address - Country:US
Practice Address - Phone:520-792-2170
Practice Address - Fax:520-792-9702
Is Sole Proprietor?:No
Enumeration Date:2008-07-02
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA1110231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist