Provider Demographics
NPI:1881642684
Name:DUNSMORE, DIANE H (MS)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:H
Last Name:DUNSMORE
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1753 NETHANIA FARM RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLNTON
Mailing Address - State:GA
Mailing Address - Zip Code:30817-2428
Mailing Address - Country:US
Mailing Address - Phone:706-359-7805
Mailing Address - Fax:706-359-0721
Practice Address - Street 1:1753 NETHANIA FARM RD.
Practice Address - Street 2:
Practice Address - City:LINCOLNTON
Practice Address - State:GA
Practice Address - Zip Code:30817
Practice Address - Country:US
Practice Address - Phone:706-359-7805
Practice Address - Fax:706-350-0721
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-04
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA314235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist