Provider Demographics
NPI:1811271067
Name:RAY, DANIELLE LYNN (MS CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:LYNN
Last Name:RAY
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 1:104 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-5503
Mailing Address - Country:US
Mailing Address - Phone:918-272-8100
Mailing Address - Fax:
Practice Address - Street 1:104 W 10TH ST
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-5503
Practice Address - Country:US
Practice Address - Phone:918-272-8100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3816235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist