Provider Demographics
NPI:1669451183
Name:JABBOUR, DANEEN JO (AUD)
Entity Type:Individual
Prefix:DR
First Name:DANEEN
Middle Name:JO
Last Name:JABBOUR
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4082
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-4082
Mailing Address - Country:US
Mailing Address - Phone:330-665-5200
Mailing Address - Fax:
Practice Address - Street 1:799 WHITE POND DR STE D
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-1189
Practice Address - Country:US
Practice Address - Phone:330-665-5200
Practice Address - Fax:330-665-5400
Is Sole Proprietor?:No
Enumeration Date:2006-01-12
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
OHA-01144231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHA-01144OtherOHIO SPEECH AND HEARING PROFESSIONAL BOARD
OH2375460Medicaid