Provider Demographics
NPI:1760048730
Name:GIARRATANO, DANIELLE JACQUELINE SHORE (MA, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:JACQUELINE SHORE
Last Name:GIARRATANO
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:JACQUELINE
Other - Last Name:SHORE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 SW 10TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33315-1621
Mailing Address - Country:US
Mailing Address - Phone:772-236-0355
Mailing Address - Fax:
Practice Address - Street 1:1522 SW 10TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33315-1621
Practice Address - Country:US
Practice Address - Phone:772-236-0355
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-15
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA16027235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLSA16027OtherSPEECH-LANGUAGE PATHOLOGY LICENSE