Provider Demographics
NPI:1790092427
Name:LILKER, DANIELLE BROOKE (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:BROOKE
Last Name:LILKER
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 BEACH 144TH ST
Mailing Address - Street 2:
Mailing Address - City:NEPONSIT
Mailing Address - State:NY
Mailing Address - Zip Code:11694-1113
Mailing Address - Country:US
Mailing Address - Phone:917-406-0155
Mailing Address - Fax:718-318-1488
Practice Address - Street 1:172 BEACH 144TH ST
Practice Address - Street 2:
Practice Address - City:NEPONSIT
Practice Address - State:NY
Practice Address - Zip Code:11694-1113
Practice Address - Country:US
Practice Address - Phone:917-406-0155
Practice Address - Fax:718-318-1488
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2010-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018915-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist