Provider Demographics
NPI:1982936795
Name:FERGUSON, DANIELLE C
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:C
Last Name:FERGUSON
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 1:1101 W TOPEKA DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-5588
Mailing Address - Country:US
Mailing Address - Phone:602-677-8345
Mailing Address - Fax:623-533-6920
Practice Address - Street 1:1101 W TOPEKA DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-5588
Practice Address - Country:US
Practice Address - Phone:602-677-8345
Practice Address - Fax:623-533-6920
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-03
Last Update Date:2010-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA65922355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant