Provider Demographics
NPI:1942644497
Name:PY, DANIELLE DIANE (MS, CCC-SLP)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:DIANE
Last Name:PY
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 1:3300 HARD ROCK CT
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-9431
Mailing Address - Country:US
Mailing Address - Phone:980-290-0972
Mailing Address - Fax:
Practice Address - Street 1:3300 HARD ROCK CT
Practice Address - Street 2:
Practice Address - City:INDIAN TRAIL
Practice Address - State:NC
Practice Address - Zip Code:28079-9431
Practice Address - Country:US
Practice Address - Phone:980-290-0972
Practice Address - Fax:704-684-4328
Is Sole Proprietor?:No
Enumeration Date:2013-04-26
Last Update Date:2020-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC10321235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist