| Doctor Name: | DIANE HEIDT |
| NPI Number: | 1912321670 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | SP-6219 |
| Business Practice Address: | 19543 Lunn Rd Strongsville, OH - 441494915 |
| Business Phone Number: | 4402685914 |
| Business Fax Number: | 4408463227 |
| Mailing Address: | 19543 Lunn Rd, STRONGSVILLE |
| State: | OH |
| Postal Code: | 441494915 |
| Phone Number: | 4402685914 |
| Fax Number: | 4408463227 |
| NPI Enumeration Date: | 02/14/2014 |
| NPI Last Update Date: | 02/14/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 235Z00000X |
| License Number: | SP-6219 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| 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 |