Provider Demographics
NPI:1164874582
Name:MUISE, DANIELLE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:MUISE
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:MA
Mailing Address - Zip Code:02458-1026
Mailing Address - Country:US
Mailing Address - Phone:508-404-8933
Mailing Address - Fax:
Practice Address - Street 1:4 BEECH ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:MA
Practice Address - Zip Code:02458-1026
Practice Address - Country:US
Practice Address - Phone:508-404-8933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-09
Last Update Date:2016-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA9578235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist