Healthcare Provider Details

I. General information

NPI: 1639340326
Provider Name (Legal Business Name): DIANNA HUTCHINSON SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2008
Last Update Date: 11/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3720 QUEEN CT SW SUITE 1
CEDAR RAPIDS IA
52404-4735
US

IV. Provider business mailing address

205 W WACKER DR SUITE 1020
CHICAGO IL
60606-1216
US

V. Phone/Fax

Practice location:
  • Phone: 319-364-0300
  • Fax: 319-364-4043
Mailing address:
  • Phone: 312-640-0329
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number00785
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: