Provider Demographics
NPI:1336319425
Name:CHERUBIN, DANIELLE E (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:CHERUBIN
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 1:2620 SE MARICAMP RD
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-5582
Mailing Address - Country:US
Mailing Address - Phone:352-351-8883
Mailing Address - Fax:352-351-4219
Practice Address - Street 1:611 W PARK ST
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2500
Practice Address - Country:US
Practice Address - Phone:217-326-2911
Practice Address - Fax:217-344-8047
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA11408235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4117OtherHAMP
IL113326OtherHEALTHLINK
IL203OtherBLUE CROSS
IL7216OtherPERSONALCARE
IL203OtherBLUE CROSS