Provider Demographics
NPI:1558039388
Name:DESANTIS, DANIELLE N (CF-SLP, TSSLD)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:N
Last Name:DESANTIS
Suffix:
Gender:F
Credentials:CF-SLP, TSSLD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:79 BERKSHIRE LN
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10309-3307
Mailing Address - Country:US
Mailing Address - Phone:917-842-0986
Mailing Address - Fax:
Practice Address - Street 1:79 BERKSHIRE LN
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3307
Practice Address - Country:US
Practice Address - Phone:917-842-0986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-06
Last Update Date:2021-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist