Provider Demographics
NPI:1780877282
Name:HIZER, DANIELLE MERRICK (MS-CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MERRICK
Last Name:HIZER
Suffix:
Gender:F
Credentials:MS-CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 WELL SPRING DR
Mailing Address - Street 2:LEGACY HEALTHCARE
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:24710
Mailing Address - Country:US
Mailing Address - Phone:336-545-6357
Mailing Address - Fax:
Practice Address - Street 1:4100 WELL SPRING DR
Practice Address - Street 2:LEGACY HEALTHCARE
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:24710
Practice Address - Country:US
Practice Address - Phone:336-545-6357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6494235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist