Healthcare Provider Details

I. General information

NPI: 1912135518
Provider Name (Legal Business Name): DANIELLE MCGINLEY ULLYOTT M.A. CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 1ST ST
HEALDSBURG CA
95448-3939
US

IV. Provider business mailing address

5021 DEERWOOD DR
SANTA ROSA CA
95403-7511
US

V. Phone/Fax

Practice location:
  • Phone: 707-431-3440
  • Fax:
Mailing address:
  • Phone: 717-350-6111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number17477
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: