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General NPI Number Information
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NPI Number | 1235557786
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Entity Type | Individual
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Provider Name | DIANA HARMON
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Gender | Female
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Dates
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Enumeration Date | 04/02/2014
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Last Update Date | 03/23/2017
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Provider Practice Location Address
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Address Line | 15941 HARLEM AVE # 118
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City | TINLEY PARK
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State | IL
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Zip | 60477-1609
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Country | US
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Telephone | 708-476-1581
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Fax | 844-411-8972
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Provider Business Mailing Address
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Address Line | 15941 HARLEM AVE # 118
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City | TINLEY PARK
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State | IL
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Zip | 60477-1609
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Country | US
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Telephone | 708-476-1581
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Fax | 184-441-1897
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 146.003021
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License Number State | IL
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