Individual
MRS. DIANE MARSH DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA CCC-A
Contact information
Practice address
4747-8 NESCONSET HWY, PORT JEFFERSON STATION, NY 11776-2878
(631) 331-6455
Mailing address
21 WOODCHUCK PATH, WADING RIVER, NY 11792-2124
(631) 929-6610
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
882
NY
237600000X
Audiologist-Hearing Aid Fitter
882
NY
Other
Enumeration date
11/16/2008
Last updated
11/16/2008
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