Provider Demographics
NPI:1063633196
Name:DANIELLE A MARSHALL SPEECH-LANGUAGE CONSULTING SERVICES
Entity Type:Organization
Organization Name:DANIELLE A MARSHALL SPEECH-LANGUAGE CONSULTING SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:ANNETTE
Authorized Official - Last Name:MARSHALL
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, CCC-SLP-L
Authorized Official - Phone:708-705-7152
Mailing Address - Street 1:16036 AVALON AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH HOLLAND
Mailing Address - State:IL
Mailing Address - Zip Code:60473-1844
Mailing Address - Country:US
Mailing Address - Phone:708-566-4158
Mailing Address - Fax:708-566-4158
Practice Address - Street 1:16036 AVALON AVE
Practice Address - Street 2:
Practice Address - City:SOUTH HOLLAND
Practice Address - State:IL
Practice Address - Zip Code:60473-1844
Practice Address - Country:US
Practice Address - Phone:708-566-4158
Practice Address - Fax:708-566-4158
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-02
Last Update Date:2009-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1467007298251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health