Provider Demographics
NPI:1194503607
Name:ALESNA, DIANNE (SLPA)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:
Last Name:ALESNA
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17180 W SWEETWATER AVE UNIT 1032
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-3402
Mailing Address - Country:US
Mailing Address - Phone:267-517-2276
Mailing Address - Fax:
Practice Address - Street 1:17161 W BAJADA RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85387-1091
Practice Address - Country:US
Practice Address - Phone:623-556-5880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-18
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA143942355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant