Doctor Name: | MRS. DIANE KAY RIESE |
NPI Number: | 1427330604 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 006766-1 |
Business Practice Address: | 38 Meadowbrook Ln Central Square, NY - 130362370 |
Business Phone Number: | 3156763296 |
Business Fax Number: | |
Mailing Address: | 38 Meadowbrook Ln, CENTRAL SQUARE |
State: | NY |
Postal Code: | 130362370 |
Phone Number: | 3156763296 |
Fax Number: | |
NPI Enumeration Date: | 09/14/2011 |
NPI Last Update Date: | 09/14/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 006766-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
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 |