Provider Demographics
NPI:1578298972
Name:HENRIQUEZ, DIANA CAROLINA
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:CAROLINA
Last Name:HENRIQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150A N BROADWAY APT 2C
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10603-3616
Mailing Address - Country:US
Mailing Address - Phone:914-844-1153
Mailing Address - Fax:
Practice Address - Street 1:22 S HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:ELMSFORD
Practice Address - State:NY
Practice Address - Zip Code:10523-3603
Practice Address - Country:US
Practice Address - Phone:914-592-4057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-19
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist