Provider Demographics
NPI:1912254301
Name:SZEMPRUCH, DANIELLE JUSTINE
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:JUSTINE
Last Name:SZEMPRUCH
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 1:2320 CORPORAL KENNEDY ST
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1449
Mailing Address - Country:US
Mailing Address - Phone:718-279-1666
Mailing Address - Fax:
Practice Address - Street 1:2320 CORPORAL KENNEDY ST
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1449
Practice Address - Country:US
Practice Address - Phone:718-279-1666
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-06
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist