Provider Demographics
NPI:1427362292
Name:DANIELS, TERI J (SLP)
Entity Type:Individual
Prefix:MRS
First Name:TERI
Middle Name:J
Last Name:DANIELS
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 1:117 HAMPTONS GRANT CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29209-1972
Mailing Address - Country:US
Mailing Address - Phone:803-783-9855
Mailing Address - Fax:
Practice Address - Street 1:117 HAMPTONS GRANT CT
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29209-1972
Practice Address - Country:US
Practice Address - Phone:803-783-9855
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-03
Last Update Date:2010-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC448235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist