Provider Demographics
NPI:1851546618
Name:DEAN, DIANA CATHERINE (MA, CCC)
Entity Type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:CATHERINE
Last Name:DEAN
Suffix:
Gender:F
Credentials:MA, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6659 KIMBALL DR
Mailing Address - Street 2:C304
Mailing Address - City:GIF HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335
Mailing Address - Country:US
Mailing Address - Phone:253-851-6922
Mailing Address - Fax:253-627-5367
Practice Address - Street 1:6659 KIMBALL DR
Practice Address - Street 2:C304
Practice Address - City:GIF HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98335
Practice Address - Country:US
Practice Address - Phone:253-851-6922
Practice Address - Fax:253-627-5367
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALL00003591235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist