Provider Demographics
NPI:1851989909
Name:REITINGER, DANIELLE NICOLE (MA)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:NICOLE
Last Name:REITINGER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:NICOLE
Other - Last Name:REITINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA-CCC
Mailing Address - Street 1:32967 REDWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:AVON LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44012-1441
Mailing Address - Country:US
Mailing Address - Phone:440-933-5145
Mailing Address - Fax:440-933-6230
Practice Address - Street 1:32967 REDWOOD BLVD
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-1441
Practice Address - Country:US
Practice Address - Phone:440-933-5145
Practice Address - Fax:440-933-6230
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-05
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP14504235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist