Healthcare Provider Details

I. General information

NPI: 1427352467
Provider Name (Legal Business Name): DANIELLE MARIE WRAY SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2011
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7275 W VINEYARD RD
LAVEEN AZ
85339-9805
US

IV. Provider business mailing address

15634 S 43RD WAY
PHOENIX AZ
85048-8804
US

V. Phone/Fax

Practice location:
  • Phone: 608-605-8540
  • Fax:
Mailing address:
  • Phone: 480-390-2452
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2355S0801X
TaxonomySpeech-Language Assistant
License NumberSLPA6914
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: