Provider Demographics
NPI:1538356753
Name:DALTON, DIANE KAY (MS CCC/SLP)
Entity type:Individual
Prefix:MR
First Name:DIANE
Middle Name:KAY
Last Name:DALTON
Suffix:
Gender:F
Credentials:MS CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:326 MEADOWLAKES DR
Mailing Address - Street 2:
Mailing Address - City:MEADOWLAKES
Mailing Address - State:TX
Mailing Address - Zip Code:78654-7123
Mailing Address - Country:US
Mailing Address - Phone:830-798-6641
Mailing Address - Fax:830-798-1871
Practice Address - Street 1:326 MEADOWLAKES DR
Practice Address - Street 2:
Practice Address - City:MEADOWLAKES
Practice Address - State:TX
Practice Address - Zip Code:78654-7123
Practice Address - Country:US
Practice Address - Phone:830-798-6641
Practice Address - Fax:830-798-1871
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19300235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist