Individual
MRS. E. DIANE SISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
7423 MALLARD DR, MOBILE, AL 36695-4267
(251) 607-7232
Mailing address
7423 MALLARD DR, MOBILE, AL 36695-4267
(251) 607-7232
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
2327
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-31746
BLUE CROSS PROVIDER NUMBE
AL
Enumeration date
10/25/2006
Last updated
07/08/2007
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