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General NPI Number Information
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NPI Number | 1144959503
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Entity Type | Individual
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Provider Name | RAGAN DANIELLE MIDDLETON SLPMI
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Gender | Female
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Dates
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Enumeration Date | 06/09/2022
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Last Update Date | 06/09/2022
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Provider Practice Location Address
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Address Line | 1751 DANCY BLVD STE 2
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City | HORN LAKE
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State | MS
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Zip | 38637-1916
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Country | US
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Telephone | 901-292-5313
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Fax | 901-867-1603
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Provider Business Mailing Address
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Address Line | 11315 MCCORMICK RD
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City | ARLINGTON
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State | TN
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Zip | 38002-9512
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Country | US
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Telephone | 901-461-7633
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Fax | 901-867-1603
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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 | 4921
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License Number State | MS
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