Provider Demographics
NPI:1689281230
Name:SMITH, DANNA VERASTEGUI (MS, CF-SLP)
Entity Type:Individual
Prefix:
First Name:DANNA
Middle Name:VERASTEGUI
Last Name:SMITH
Suffix:
Gender:F
Credentials:MS, CF-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 HOLIDAY RD
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-1113
Mailing Address - Country:US
Mailing Address - Phone:319-610-9223
Mailing Address - Fax:
Practice Address - Street 1:523 E 5TH ST
Practice Address - Street 2:
Practice Address - City:SOLON
Practice Address - State:IA
Practice Address - Zip Code:52333-9620
Practice Address - Country:US
Practice Address - Phone:319-624-3492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA105473235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist