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General NPI Number Information
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NPI Number | 1205003415
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Entity Type | Individual
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Provider Name | DALENE D. MACWILLIAM M.S.,C.C.C,/SLP
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Gender | Female
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Dates
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Enumeration Date | 05/15/2008
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Last Update Date | 08/12/2014
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Provider Practice Location Address
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Address Line | 2966 BAY OAKS DR
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City | DALLAS
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State | TX
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Zip | 75229-4912
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Country | US
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Telephone | 214-732-6920
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Fax | 214-732-6920
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Provider Business Mailing Address
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Address Line | 2966 BAY OAKS DR
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City | DALLAS
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State | TX
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Zip | 75229-4912
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Country | US
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Telephone | 214-732-6920
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Fax | 214-732-6920
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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 | 109885
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License Number State | TX
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