Provider Demographics
NPI:1265967111
Name:KNOWLES, DANIEL DUANE (MA, CCC-SLP)
Entity type:Individual
Prefix:MR
First Name:DANIEL
Middle Name:DUANE
Last Name:KNOWLES
Suffix:
Gender:M
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:969 N LA CIENEGA BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4709
Mailing Address - Country:US
Mailing Address - Phone:310-734-7695
Mailing Address - Fax:
Practice Address - Street 1:969 N LA CIENEGA BLVD
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4709
Practice Address - Country:US
Practice Address - Phone:310-734-7695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-28
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26095235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist