Doctor Name: | MR. DANIEL MARK GIFFORD |
NPI Number: | 1811178478 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS CCCSLP |
License Number: | 464154 |
Business Practice Address: | 1701 Sharp Rd Lakeview Specialty Hospital Waterford, WI - 53185 |
Business Phone Number: | 2625347297 |
Business Fax Number: | |
Mailing Address: | 316 N Milwaukee St, Suite 208 MILWAUKEE |
State: | WI |
Postal Code: | 532025803 |
Phone Number: | 8883899030 |
Fax Number: | |
NPI Enumeration Date: | 11/23/2007 |
NPI Last Update Date: | 11/23/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 464154 |
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 |