Provider Demographics
NPI:1811773856
Name:BERNARD, DANISHA MARIA
Entity type:Individual
Prefix:
First Name:DANISHA
Middle Name:MARIA
Last Name:BERNARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 LENOX LN
Mailing Address - Street 2:
Mailing Address - City:SOUTH EASTON
Mailing Address - State:MA
Mailing Address - Zip Code:02375-1842
Mailing Address - Country:US
Mailing Address - Phone:484-926-3938
Mailing Address - Fax:
Practice Address - Street 1:96 2ND AVE
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-5153
Practice Address - Country:US
Practice Address - Phone:484-926-3938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA331486235Z00000X
RISP01659235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist