Provider Demographics
NPI:1760628853
Name:COWAN, DANIELLE KATHLEEN (SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:KATHLEEN
Last Name:COWAN
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WEST DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-1461
Mailing Address - Country:US
Mailing Address - Phone:516-420-6921
Mailing Address - Fax:
Practice Address - Street 1:150 ABBEY LN
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756-4042
Practice Address - Country:US
Practice Address - Phone:516-520-6003
Practice Address - Fax:516-796-6341
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-19
Last Update Date:2012-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY014258-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist