Individual
DIANE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS CCC-SLP
Contact information
Practice address
900 2ND ST NE, SUITE 306, WASHINGTON, DC 20002-3557
(202) 544-2320
(202) 544-2321
Mailing address
900 2ND ST NE, SUITE 306, WASHINGTON, DC 20002-3557
(202) 544-2320
(202) 544-2321
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SLP000173
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SLP000173
DC DEPT OF HEALTH PROFESSIONAL LICENSING ADMINISTRATION
DC
Enumeration date
06/12/2012
Last updated
06/12/2012
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