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General NPI Number Information
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NPI Number | 1003067109
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Entity Type | Organization
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Legal Business Name | DIANA G MASKER AND ASSOCIATES INC
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Dates
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Enumeration Date | 10/07/2008
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Last Update Date | 10/07/2008
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Provider Practice Location Address
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Address Line | 3040 N WICKHAM RD STE 4
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City | MELBOURNE
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State | FL
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Zip | 32935-2369
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Country | US
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Telephone | 321-751-1443
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Fax | 321-751-1448
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Provider Business Mailing Address
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Address Line | 3040 N WICKHAM RD STE 4
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City | MELBOURNE
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State | FL
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Zip | 32935-2369
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Country | US
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Telephone | 321-751-1443
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Fax | 321-751-1448
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Authorized Official
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Title or Position | OWNER/SPEECH-LANGUAGE PATHOLOGIST
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Name | MS. DIANA G MASKER
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Credential | M.A., CCC
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Telephone | 321-751-1443
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | SA 3134
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License Number State | FL
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