Provider Demographics
NPI:1326293739
Name:DANNELS, CAROLYN LOUISE (M S CCC-SLP)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:LOUISE
Last Name:DANNELS
Suffix:
Gender:F
Credentials:M S CCC-SLP
Other - Prefix:
Other - First Name:CAROLYN
Other - Middle Name:LOUISE
Other - Last Name:ANTONETTI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:M S CCC-SLP
Mailing Address - Street 1:241 NORTH ROAD
Mailing Address - Street 2:SUITE 400A
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601
Mailing Address - Country:US
Mailing Address - Phone:845-431-8803
Mailing Address - Fax:845-483-5688
Practice Address - Street 1:15 HASTINGS DR
Practice Address - Street 2:
Practice Address - City:BEACON
Practice Address - State:NY
Practice Address - Zip Code:12508-2056
Practice Address - Country:US
Practice Address - Phone:845-838-4440
Practice Address - Fax:845-838-8883
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-26
Last Update Date:2022-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006898-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist