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General NPI Number Information
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NPI Number | 1427539188
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Entity Type | Individual
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Provider Name | DANIELLE M VIROSTKO MA
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 494 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1470
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Country | US
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Telephone | 174-036-9365
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Fax | 740-369-0812
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Provider Business Mailing Address
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Address Line | 494 W CENTRAL AVE
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City | DELAWARE
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State | OH
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Zip | 43015-1470
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Country | US
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Telephone | 174-036-9365
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Fax | 740-369-0812
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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 | SP10932
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License Number State | OH
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