Doctor Name: | MRS. DANIELLE NICOLE LARSON |
NPI Number: | 1457696726 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.A. CFY-SLP |
License Number: | 3667-154 |
Business Practice Address: | 314 Service Rd Spooner, WI - 548016200 |
Business Phone Number: | 7156352518 |
Business Fax Number: | 8662458064 |
Mailing Address: | Po Box 3497, STURTEVANT |
State: | WI |
Postal Code: | 531770300 |
Phone Number: | 8882011040 |
Fax Number: | 8662458064 |
NPI Enumeration Date: | 11/28/2012 |
NPI Last Update Date: | 08/18/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 3667-154 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WI |
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 |