Provider Demographics
NPI:1033005277
Name:DIAZ, DAYANNA EUNICE (MS, CF-SLP, TSSLD)
Entity type:Individual
Prefix:
First Name:DAYANNA
Middle Name:EUNICE
Last Name:DIAZ
Suffix:
Gender:F
Credentials:MS, CF-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3777 RIVERS POINTE WAY APT 24
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13090-4949
Mailing Address - Country:US
Mailing Address - Phone:301-433-1394
Mailing Address - Fax:
Practice Address - Street 1:115 CONTINUUM DR STE 1A
Practice Address - Street 2:
Practice Address - City:LIVERPOOL
Practice Address - State:NY
Practice Address - Zip Code:13088-4387
Practice Address - Country:US
Practice Address - Phone:315-450-4898
Practice Address - Fax:315-449-9898
Is Sole Proprietor?:No
Enumeration Date:2025-06-16
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist