Individual
MIKI DIANE SHIBATA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, CCC-SLP
Contact information
Practice address
200 Q ST NE, APT 2237, WASHINGTON, DC 20002-2390
(904) 441-0302
Mailing address
200 Q ST NE, APT 2237, WASHINGTON, DC 20002-2390
(904) 441-0302
(301) 208-6685
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
08162
MD
235Z00000X
Speech-Language Pathologist
Primary
SLP0113
DC
Other
Enumeration date
06/09/2016
Last updated
09/02/2019
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