Healthcare Provider Details

I. General information

NPI: 1114362142
Provider Name (Legal Business Name): DIANA L ALLEN SLPA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2013
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 N GILBERT RD APT 1107
GILBERT AZ
85234-8611
US

IV. Provider business mailing address

1101 N GILBERT RD APT 1107
GILBERT AZ
85234-8611
US

V. Phone/Fax

Practice location:
  • Phone: 602-456-2936
  • Fax:
Mailing address:
  • Phone: 602-456-2936
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License Number8266
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: