Provider Demographics
NPI:1508090218
Name:FAITH, DANNA MARIA (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:MARIA
Last Name:FAITH
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 1:429 LILLY BELL LN
Mailing Address - Street 2:
Mailing Address - City:FREEPORT
Mailing Address - State:FL
Mailing Address - Zip Code:32439-7622
Mailing Address - Country:US
Mailing Address - Phone:850-974-4824
Mailing Address - Fax:
Practice Address - Street 1:429 LILLY BELL LN
Practice Address - Street 2:
Practice Address - City:FREEPORT
Practice Address - State:FL
Practice Address - Zip Code:32439-7622
Practice Address - Country:US
Practice Address - Phone:850-974-4824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-08
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3503235Z00000X
FLSA14345235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist