Doctor Name: | DANIELLE FONTANELLA |
NPI Number: | 1669828786 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5708 |
Business Practice Address: | 1417 Stuart Engals Blvd Suite 201 Mount Pleasant, SC - 294643353 |
Business Phone Number: | 8433889990 |
Business Fax Number: | 8433880349 |
Mailing Address: | 1150 Hungryneck Blvd, Suite C364 MOUNT PLEASANT |
State: | SC |
Postal Code: | 294643484 |
Phone Number: | 8433889990 |
Fax Number: | 8433880349 |
NPI Enumeration Date: | 05/07/2016 |
NPI Last Update Date: | 05/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 5708 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
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 |