Provider Demographics
NPI:1821717265
Name:COLWELL, DANIELLE (MS CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:COLWELL
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 LANCASTER TER APT 3
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-2281
Mailing Address - Country:US
Mailing Address - Phone:414-294-8553
Mailing Address - Fax:
Practice Address - Street 1:140 GOULD ST STE 290
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02494-2397
Practice Address - Country:US
Practice Address - Phone:781-400-2605
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA77579235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist