Provider Demographics
NPI:1881911444
Name:DENOVELLIS SCOPINICH, DANIELLE (MA SLP-CCC)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:DENOVELLIS SCOPINICH
Suffix:
Gender:F
Credentials:MA SLP-CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15653 102ND ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD BEACH
Mailing Address - State:NY
Mailing Address - Zip Code:11414-3207
Mailing Address - Country:US
Mailing Address - Phone:347-647-0767
Mailing Address - Fax:
Practice Address - Street 1:15653 102ND ST
Practice Address - Street 2:
Practice Address - City:HOWARD BEACH
Practice Address - State:NY
Practice Address - Zip Code:11414-3207
Practice Address - Country:US
Practice Address - Phone:347-647-0767
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-22
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018305235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist