Provider Demographics
NPI:1790994457
Name:OLIVA, DANIELLE MARIE TACHE (M S, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE TACHE
Last Name:OLIVA
Suffix:
Gender:F
Credentials:M S, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-3216
Mailing Address - Country:US
Mailing Address - Phone:978-388-7274
Mailing Address - Fax:
Practice Address - Street 1:253 SCHOOL ST
Practice Address - Street 2:
Practice Address - City:GROVELAND
Practice Address - State:MA
Practice Address - Zip Code:01834-2021
Practice Address - Country:US
Practice Address - Phone:978-521-8856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0924235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist