Provider Demographics
NPI:1225452360
Name:MACIELEWICZ, DANIELLE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:MACIELEWICZ
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5200 COUNTY ROAD 13
Mailing Address - Street 2:
Mailing Address - City:KANSAS
Mailing Address - State:OH
Mailing Address - Zip Code:44841-9617
Mailing Address - Country:US
Mailing Address - Phone:419-986-6650
Mailing Address - Fax:
Practice Address - Street 1:5200 COUNTY ROAD 13
Practice Address - Street 2:
Practice Address - City:KANSAS
Practice Address - State:OH
Practice Address - Zip Code:44841-9617
Practice Address - Country:US
Practice Address - Phone:419-986-6650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.3593235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist