Doctor Name: | DIEDRE ANNE DENNIS |
NPI Number: | 1104054246 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MA, CCC/SLP |
License Number: | 2202004567 |
Business Practice Address: | 2121 Eisenhower Ave Suite #234 Alexandria, VA - 223144698 |
Business Phone Number: | 7038500872 |
Business Fax Number: | |
Mailing Address: | 2121 Eisenhower Ave, Suite #234 ALEXANDRIA |
State: | VA |
Postal Code: | 223144698 |
Phone Number: | 7038500872 |
Fax Number: | |
NPI Enumeration Date: | 06/28/2009 |
NPI Last Update Date: | 08/28/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2202004567 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | VA |
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 |