Provider Demographics
NPI:1710132683
Name:DESMONIE, DANIELLE MARIE (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:DESMONIE
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:SUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:50 BALMORAL CT
Mailing Address - Street 2:
Mailing Address - City:VALATIE
Mailing Address - State:NY
Mailing Address - Zip Code:12184-5001
Mailing Address - Country:US
Mailing Address - Phone:518-330-1475
Mailing Address - Fax:
Practice Address - Street 1:50 BALMORAL CT
Practice Address - Street 2:
Practice Address - City:VALATIE
Practice Address - State:NY
Practice Address - Zip Code:12184-5001
Practice Address - Country:US
Practice Address - Phone:518-330-1475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-19
Last Update Date:2008-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011228-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist