Provider Demographics
NPI:1700168630
Name:KEY, DIANE MCGREGOR (TEACHER OF VISUALLY)
Entity Type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:MCGREGOR
Last Name:KEY
Suffix:
Gender:F
Credentials:TEACHER OF VISUALLY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 GOLDSMITH LANE
Mailing Address - Street 2:VIPS
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218
Mailing Address - Country:US
Mailing Address - Phone:502-636-3207
Mailing Address - Fax:502-636-0024
Practice Address - Street 1:1906 GOLDSMITH LANE
Practice Address - Street 2:VIPS
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218
Practice Address - Country:US
Practice Address - Phone:502-636-3207
Practice Address - Fax:502-636-0024
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2011-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency