Provider Demographics
NPI:1063663847
Name:WINELAND, DARIA (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DARIA
Middle Name:
Last Name:WINELAND
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1735 ORANGEWOOD CIR
Mailing Address - Street 2:
Mailing Address - City:BARTOW
Mailing Address - State:FL
Mailing Address - Zip Code:33830-9273
Mailing Address - Country:US
Mailing Address - Phone:863-534-1188
Mailing Address - Fax:
Practice Address - Street 1:1735 ORANGEWOOD CIR
Practice Address - Street 2:
Practice Address - City:BARTOW
Practice Address - State:FL
Practice Address - Zip Code:33830-9273
Practice Address - Country:US
Practice Address - Phone:863-534-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-09
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA 7454235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist