Delisa, Diana C
Delisa, Diana C is an individual health care provider with primary practice located at 1245 Farmington Ave Suite 2, Farmington CT 06107-2667. She recently has only one registered license in Speech, Language and Hearing Service Providers / Audiologist, which is considered as her primary health care specialty. Delisa, Diana C can be contacted via phone (860) 521-1213.Contact Information
Primary practice address
1245 Farmington Ave Suite 2
Farmington CT 06107-2667
Phone: (860) 521-1213
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Audiologist | 231H00000X | 000134 | Connecticut |
Profile Details
| NPI number | 1093713257 |
|---|---|
| LBN Legal business name | Delisa, Diana C |
| Credentials | AUD |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2005 |
| Last updated | Mar 25th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1093713257 | NPPES |
| Connecticut | MEDICAID | 4053195 |
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