Provider Demographics
NPI:1144467630
Name:LOFT, DIANE V (CCC-SP)
Entity type:Individual
Prefix:MRS
First Name:DIANE
Middle Name:V
Last Name:LOFT
Suffix:
Gender:F
Credentials:CCC-SP
Other - Prefix:MRS
Other - First Name:DIANE
Other - Middle Name:V
Other - Last Name:LOFT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CCC-SP
Mailing Address - Street 1:5 ADRIAN CIR
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7901
Mailing Address - Country:US
Mailing Address - Phone:914-381-1852
Mailing Address - Fax:914-381-1853
Practice Address - Street 1:5 ADRIAN CIR
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7901
Practice Address - Country:US
Practice Address - Phone:914-381-1852
Practice Address - Fax:914-381-1853
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003688-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist