Provider Demographics
NPI:1295219673
Name:DANIEL REESE, MA, CCC-SLP PLLC
Entity Type:Organization
Organization Name:DANIEL REESE, MA, CCC-SLP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SPEECH-LANGUAGE PATHOLOGIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:REESE
Authorized Official - Suffix:
Authorized Official - Credentials:MA, CCC-SLP
Authorized Official - Phone:512-940-6285
Mailing Address - Street 1:PO BOX 4558
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78765-4558
Mailing Address - Country:US
Mailing Address - Phone:512-940-6285
Mailing Address - Fax:
Practice Address - Street 1:1619 W 6TH ST STE 3
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78703-5377
Practice Address - Country:US
Practice Address - Phone:512-940-6285
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-20
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0700XAmbulatory Health Care FacilitiesClinic/CenterHearing and Speech