Provider Demographics
NPI:1609356427
Name:MARNHOLTZ, DIANE K
Entity type:Individual
Prefix:
First Name:DIANE
Middle Name:K
Last Name:MARNHOLTZ
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 1:12709 SMART RD
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-8900
Mailing Address - Country:US
Mailing Address - Phone:816-986-2360
Mailing Address - Fax:
Practice Address - Street 1:12709 SMART RD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-8900
Practice Address - Country:US
Practice Address - Phone:816-986-2360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist