Provider Demographics
NPI:1013623198
Name:WALSH, DANIELLE MARIE (MS CCC-SLP, MSW)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:WALSH
Suffix:
Gender:F
Credentials:MS CCC-SLP, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:104 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:EATONTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07724-3406
Mailing Address - Country:US
Mailing Address - Phone:267-885-9758
Mailing Address - Fax:
Practice Address - Street 1:166 PATTERSON AVE STE 8
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702-4166
Practice Address - Country:US
Practice Address - Phone:732-842-6600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-23
Last Update Date:2023-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01174200235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist