Provider Demographics
NPI:1558689125
Name:DAVIES, DAYNA MICHELE (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DAYNA
Middle Name:MICHELE
Last Name:DAVIES
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 1:105 FORTUNE CT
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-1491
Mailing Address - Country:US
Mailing Address - Phone:718-644-5694
Mailing Address - Fax:
Practice Address - Street 1:32 SKIMMER LN
Practice Address - Street 2:
Practice Address - City:PORT MONMOUTH
Practice Address - State:NJ
Practice Address - Zip Code:07758-1662
Practice Address - Country:US
Practice Address - Phone:718-644-5694
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-06
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019904235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist