Doctor Name: | MRS. ROCHELLE DENISE DIESTELKAMP |
NPI Number: | 1033501986 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CCC-SLP |
License Number: | 5514 |
Business Practice Address: | 1511 Nashville Hwy Ste A Columbia, TN - 384012070 |
Business Phone Number: | 9314907770 |
Business Fax Number: | |
Mailing Address: | 1000 Walden Creek Trce, Ste 22-3i SPRING HILL |
State: | TN |
Postal Code: | 371746502 |
Phone Number: | 4024502562 |
Fax Number: | |
NPI Enumeration Date: | 03/02/2015 |
NPI Last Update Date: | 03/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5514 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |