Provider Demographics
NPI:1811160070
Name:TOWNSEND, DIANA LEE
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:LEE
Last Name:TOWNSEND
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3023 N BALLAS RD
Mailing Address - Street 2:SUITE 675, BLDG D
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-2330
Mailing Address - Country:US
Mailing Address - Phone:314-995-9021
Mailing Address - Fax:314-995-9814
Practice Address - Street 1:3023 N BALLAS RD
Practice Address - Street 2:SUITE 675, BLDG D
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-2330
Practice Address - Country:US
Practice Address - Phone:314-995-9021
Practice Address - Fax:314-995-9814
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-09
Last Update Date:2008-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO00202231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist