Provider Demographics
NPI:1235965518
Name:TURPEN, DIANNE LEE (MS, SLP)
Entity type:Individual
Prefix:
First Name:DIANNE
Middle Name:LEE
Last Name:TURPEN
Suffix:
Gender:F
Credentials:MS, SLP
Other - Prefix:
Other - First Name:DIANNE
Other - Middle Name:LEE
Other - Last Name:HIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3124 COLLEGE AVE
Mailing Address - Street 2:
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-4748
Mailing Address - Country:US
Mailing Address - Phone:618-250-6485
Mailing Address - Fax:
Practice Address - Street 1:3124 COLLEGE AVE
Practice Address - Street 2:
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-4748
Practice Address - Country:US
Practice Address - Phone:618-250-6485
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-12
Last Update Date:2024-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36555235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist