Vodicka, Diana M
Vodicka, Diana M is an individual health care provider with primary practice located at 1190 E Paradise Dr , West Bend WI 53095-5444. She recently has only one registered license in Speech, Language and Hearing Service Providers / Speech-Language Pathologist, which is considered as her primary health care specialty. Vodicka, Diana M can be contacted via phone (262) 306-6319.Contact Information
Primary practice address
1190 E Paradise Dr
West Bend WI 53095-5444
Phone: (262) 306-6319
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Speech, Language and Hearing Service Providers / Speech-Language Pathologist | 235Z00000X | 220 | Wisconsin |
Profile Details
| NPI number | 1306036116 |
|---|---|
| LBN Legal business name | Vodicka, Diana M |
| Credentials | MS CCC/SLP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2007 |
| Last updated | Dec 5th, 2012 - about 14 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 | 1306036116 | NPPES |
| Wisconsin | MEDICAID | 42670600 |
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