Provider Demographics
NPI:1942746649
Name:CUEVO, DIAHANN (MA CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DIAHANN
Middle Name:
Last Name:CUEVO
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 MADISON PL
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-2910
Mailing Address - Country:US
Mailing Address - Phone:845-480-2918
Mailing Address - Fax:
Practice Address - Street 1:14 MADISON PL
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10603-2910
Practice Address - Country:US
Practice Address - Phone:845-480-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-18
Last Update Date:2022-10-12
Deactivation Date:2017-10-09
Deactivation Code:
Reactivation Date:2018-03-13
Provider Licenses
StateLicense IDTaxonomies
CT18.005151235Z00000X
NY027612235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist