| Doctor Name: | DR. DIANE BRACKETT |
| NPI Number: | 1285780379 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PHD |
| License Number: | 000359 |
| Business Practice Address: | 354 Hartford Tpke Hampton, CT - 062471320 |
| Business Phone Number: | 8604551404 |
| Business Fax Number: | 8604551396 |
| Mailing Address: | 173 Pond Hill Rd, MOOSUP |
| State: | CT |
| Postal Code: | 063541836 |
| Phone Number: | 8605641508 |
| Fax Number: | |
| NPI Enumeration Date: | 01/25/2007 |
| NPI Last Update Date: | 11/17/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | 000359 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CT |
| 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 |