Provider Demographics
NPI:1619574100
Name:SIBLEY, DANIELLE DEMARINO (MS-SLP-CCC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DEMARINO
Last Name:SIBLEY
Suffix:
Gender:F
Credentials:MS-SLP-CCC
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:DEMARINO
Other - Last Name:SIEGEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS-SLP-CCC
Mailing Address - Street 1:3821 LA MANCHA LN
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76205-8494
Mailing Address - Country:US
Mailing Address - Phone:194-045-3645
Mailing Address - Fax:214-466-1378
Practice Address - Street 1:3821 LA MANCHA LN
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-8494
Practice Address - Country:US
Practice Address - Phone:194-045-3645
Practice Address - Fax:214-466-1378
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX117605235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist