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General NPI Number Information
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NPI Number | 1033519202
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Entity Type | Individual
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Provider Name | DANIELLE HYDE M.A.
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Gender | Female
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Dates
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Enumeration Date | 08/25/2014
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Last Update Date | 08/25/2014
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Provider Practice Location Address
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Address Line | 8111 TIS WELL DR
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City | ALEXANDRIA
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State | VA
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Zip | 22306-3211
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Country | US
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Telephone | 814-218-4029
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Fax |
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Provider Business Mailing Address
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Address Line | 909 SECOND ST
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City | ALEXANDRIA
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State | VA
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Zip | 22314-1347
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Country | US
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Telephone | 814-218-4029
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 2202007496
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License Number State | VA
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