Provider Demographics
NPI:1194010975
Name:CREEGAN, DANIELLE JACQUELINE (MS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JACQUELINE
Last Name:CREEGAN
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:620 SCHOENHAAR DR
Mailing Address - Street 2:
Mailing Address - City:WEST BEND
Mailing Address - State:WI
Mailing Address - Zip Code:53090-2649
Mailing Address - Country:US
Mailing Address - Phone:262-306-8450
Mailing Address - Fax:
Practice Address - Street 1:620 SCHOENHAAR DR
Practice Address - Street 2:
Practice Address - City:WEST BEND
Practice Address - State:WI
Practice Address - Zip Code:53090-2649
Practice Address - Country:US
Practice Address - Phone:262-306-8450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-09
Last Update Date:2011-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3529-154235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist