Provider Demographics
NPI:1548551708
Name:MOEHLER, DIANA THERESA
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:THERESA
Last Name:MOEHLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 WOLLERTON ST
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19382-2948
Mailing Address - Country:US
Mailing Address - Phone:610-812-3666
Mailing Address - Fax:
Practice Address - Street 1:421 WOLLERTON ST
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19382-2948
Practice Address - Country:US
Practice Address - Phone:610-812-3666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-22
Last Update Date:2016-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009877235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist