Individual
DIANE JANE TAYLOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSCCCSL
Contact information
Practice address
600 S WEBSTER AVE, GREEN BAY, WI 54301-3503
(920) 432-3213
(920) 432-0614
Mailing address
262 INNSBRUCK CT, GREEN BAY, WI 54302-4944
(920) 468-3230
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
339-154
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42618800
—
WI
Enumeration date
01/30/2009
Last updated
01/30/2009
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