Individual
DIANA QUICENO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
12545 ORANGE DR STE 502, DAVIE, FL 33330
(954) 474-8048
Mailing address
7641 NW 183RD TER, HIALEAH, FL 33015-2946
(786) 280-6710
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SI2483
FL
235Z00000X
Speech-Language Pathologist
Primary
SZ8591
FL
Other
Enumeration date
04/21/2015
Last updated
06/20/2018
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