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General NPI Number Information
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NPI Number | 1063925394
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Entity Type | Individual
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Provider Name | DANIELLE NICOLE LOCASCIO M.A. CCC-SLP
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Gender | Female
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Dates
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Enumeration Date | 11/08/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 18911 INLET RD
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City | LAKEVILLE
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State | MN
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Zip | 55044-7559
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Country | US
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Telephone | 952-288-8532
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Fax |
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Provider Business Mailing Address
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Address Line | 6458 CITY WEST PKWY
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City | EDEN PRAIRIE
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State | MN
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Zip | 55344-3245
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Country | US
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Telephone | 952-767-6782
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Fax | 612-728-5301
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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 | 14151039
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number | 9800
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License Number State | MN
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