Healthcare Provider Details

I. General information

NPI: 1932459534
Provider Name (Legal Business Name): DANIELLE ANTONETTE HUFF SLP ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2012
Last Update Date: 09/12/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 CUSTER ROAD
RICHARDSON TX
75080-2703
US

IV. Provider business mailing address

320 CUSTER ROAD
RICHARDSON TX
75080-2703
US

V. Phone/Fax

Practice location:
  • Phone: 972-490-9055
  • Fax: 972-265-0392
Mailing address:
  • Phone: 972-490-9055
  • Fax: 972-265-0392

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number37065
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: