Provider Demographics
NPI:1871938795
Name:DIMINUCO, DIANE M (MS-LSLP)
Entity type:Individual
Prefix:MS
First Name:DIANE
Middle Name:M
Last Name:DIMINUCO
Suffix:
Gender:F
Credentials:MS-LSLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:554 CHRISTIANA ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-6204
Mailing Address - Country:US
Mailing Address - Phone:716-946-7387
Mailing Address - Fax:
Practice Address - Street 1:554 CHRISTIANA ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-6204
Practice Address - Country:US
Practice Address - Phone:716-946-7387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-06
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY58-008733235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist