Provider Demographics
NPI:1376659185
Name:THEOKAS, DIANNA LYNN (AUD)
Entity type:Individual
Prefix:DR
First Name:DIANNA
Middle Name:LYNN
Last Name:THEOKAS
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10470 W CHEYENNE AVE STE 120
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89129-8733
Mailing Address - Country:US
Mailing Address - Phone:702-240-2059
Mailing Address - Fax:
Practice Address - Street 1:10470 W CHEYENNE AVE STE 120
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89129-8733
Practice Address - Country:US
Practice Address - Phone:702-240-2059
Practice Address - Fax:702-240-2065
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVA-1503-DISPENSING231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter