Provider Demographics
NPI:1841824497
Name:LINCOLN, DANIELLE LORIN
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LORIN
Last Name:LINCOLN
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 1:4709 PEARL ST
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75965-1564
Mailing Address - Country:US
Mailing Address - Phone:281-224-7172
Mailing Address - Fax:
Practice Address - Street 1:415 S 1ST ST # 300A
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75901-3863
Practice Address - Country:US
Practice Address - Phone:281-224-7172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-22
Last Update Date:2020-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX413852355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant