Provider Demographics
NPI:1003990888
Name:WALTERS, DANIELLE (SPEECH THERAPIST)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:WALTERS
Suffix:
Gender:F
Credentials:SPEECH THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11016 DONELSON DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:MD
Mailing Address - Zip Code:21795-1448
Mailing Address - Country:US
Mailing Address - Phone:301-991-2693
Mailing Address - Fax:
Practice Address - Street 1:11016 DONELSON DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:MD
Practice Address - Zip Code:21795-1448
Practice Address - Country:US
Practice Address - Phone:301-991-2693
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD04156235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist