Provider Demographics
NPI:1104959196
Name:WOLFE, DIANE RALEY (MS CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:RALEY
Last Name:WOLFE
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3233 COMANCHE RD
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15241-1138
Mailing Address - Country:US
Mailing Address - Phone:412-835-0930
Mailing Address - Fax:
Practice Address - Street 1:1401 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15234-2364
Practice Address - Country:US
Practice Address - Phone:412-884-5227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL005911L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist