Provider Demographics
NPI:1609922004
Name:BATTLE, DARRELL
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:
Last Name:BATTLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 POINTE NEWPORT TER
Mailing Address - Street 2:# 206
Mailing Address - City:CASSELBERRY
Mailing Address - State:FL
Mailing Address - Zip Code:32707-7246
Mailing Address - Country:US
Mailing Address - Phone:407-672-2145
Mailing Address - Fax:
Practice Address - Street 1:1100 POINTE NEWPORT TER
Practice Address - Street 2:# 206
Practice Address - City:CASSELBERRY
Practice Address - State:FL
Practice Address - Zip Code:32707-7246
Practice Address - Country:US
Practice Address - Phone:407-672-2145
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSI 1090235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist