Provider Demographics
NPI:1265752455
Name:KING, DANIELLE C (AUD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:C
Last Name:KING
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:M
Other - Last Name:CAPERTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD
Mailing Address - Street 1:7557A DANNAHER DR.
Mailing Address - Street 2:SUITE 210
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3563
Mailing Address - Country:US
Mailing Address - Phone:865-521-8050
Mailing Address - Fax:865-544-5816
Practice Address - Street 1:7557A DANNAHER DR.
Practice Address - Street 2:SUITE 210
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37871-3563
Practice Address - Country:US
Practice Address - Phone:865-521-8050
Practice Address - Fax:865-544-5816
Is Sole Proprietor?:No
Enumeration Date:2010-06-10
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNA0000001607231H00000X, 237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3710126Medicaid