Provider Demographics
NPI:1194975391
Name:WEBBER, DIANE (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:
Last Name:WEBBER
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 COMMERCE BLVD
Mailing Address - Street 2:SUITE 107
Mailing Address - City:DICKSON CITY
Mailing Address - State:PA
Mailing Address - Zip Code:18519-1759
Mailing Address - Country:US
Mailing Address - Phone:570-489-5561
Mailing Address - Fax:570-489-5563
Practice Address - Street 1:851 COMMERCE BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:DICKSON CITY
Practice Address - State:PA
Practice Address - Zip Code:18519-1759
Practice Address - Country:US
Practice Address - Phone:570-489-5561
Practice Address - Fax:570-489-5563
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL002858L235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist