Healthcare Provider Details

I. General information

NPI: 1063710291
Provider Name (Legal Business Name): DANIELLE ROSA WALKER MA CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/11/2011
Last Update Date: 03/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2133 HOSPITAL ST
CHRISTIANSTED VI
00820-4609
US

IV. Provider business mailing address

7777 GLADES RD SUITE #215
BOCA RATON FL
33434-4194
US

V. Phone/Fax

Practice location:
  • Phone: 340-718-7997
  • Fax:
Mailing address:
  • Phone: 800-233-5976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14605
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: