Provider Demographics
NPI:1356774657
Name:MILLER, DANIELLE (MA CCC SLP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:MILLER
Suffix:
Gender:F
Credentials:MA CCC SLP
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:LANDRY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA CCC SLP
Mailing Address - Street 1:5930 GOODWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806
Mailing Address - Country:US
Mailing Address - Phone:225-281-3412
Mailing Address - Fax:
Practice Address - Street 1:2644 WOODLAND RIDGE BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-2539
Practice Address - Country:US
Practice Address - Phone:225-281-3412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-10
Last Update Date:2022-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6941235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Single Specialty