Provider Demographics
NPI:1578849212
Name:DAY, DANAE (MCD, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANAE
Middle Name:
Last Name:DAY
Suffix:
Gender:F
Credentials:MCD, CCC-SLP
Other - Prefix:MISS
Other - First Name:DANAE
Other - Middle Name:NICOLE
Other - Last Name:GUILLORY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MCD, CCC-SLP
Mailing Address - Street 1:10108 POYDRAS ST
Mailing Address - Street 2:
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-8513
Mailing Address - Country:US
Mailing Address - Phone:318-294-0133
Mailing Address - Fax:
Practice Address - Street 1:10108 POYDRAS ST
Practice Address - Street 2:
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-8513
Practice Address - Country:US
Practice Address - Phone:318-294-0133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6003235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist