Doctor Name: | DANIELLE DECKER |
NPI Number: | 1003273335 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 2513 |
Business Practice Address: | 825 E 3rd St Grove, OK - 743447973 |
Business Phone Number: | 9189647025 |
Business Fax Number: | 9189647024 |
Mailing Address: | 26315 S 545 Rd, AFTON |
State: | OK |
Postal Code: | 743316497 |
Phone Number: | 9189647025 |
Fax Number: | 9189647024 |
NPI Enumeration Date: | 01/17/2016 |
NPI Last Update Date: | 01/17/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 2513 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |