Provider Demographics
NPI:1740639335
Name:BATES, DANIELLE
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BATES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:VIOLETTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2 DAVIS POINT LN
Mailing Address - Street 2:SUITE 1A
Mailing Address - City:CAPE ELIZABETH
Mailing Address - State:ME
Mailing Address - Zip Code:04107-2620
Mailing Address - Country:US
Mailing Address - Phone:207-767-9773
Mailing Address - Fax:207-541-9212
Practice Address - Street 1:2 DAVIS POINT LN
Practice Address - Street 2:SUITE 1A
Practice Address - City:CAPE ELIZABETH
Practice Address - State:ME
Practice Address - Zip Code:04107-2620
Practice Address - Country:US
Practice Address - Phone:207-767-9773
Practice Address - Fax:207-541-9212
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEST2535235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist