Individual
MS. DIANE WERTZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
4423 NW 6TH PL, SUITE C, GAINESVILLE, FL 32607-6115
(352) 379-8555
(352) 379-8585
Mailing address
874 NW 50TH TER, GAINESVILLE, FL 32605-3171
(352) 665-1217
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA4409
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891765500
—
FL
Enumeration date
01/11/2007
Last updated
04/06/2010
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