MEDICARE: MRS. DANIELLE KALLMEYER M.A. CCC/SLP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	SP.6239	OH

General Provider Information

NPI Number	:	1235534009
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANIELLE KALLMEYER M.A. CCC/SLP

Provider Business Mailing Address
First Line	:	6116 WILSON MILLS RD
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-2105
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6116 WILSON MILLS RD
Second Line	:
City	:	MAYFIELD VILLAGE
State	:	OH
Zip	:	44143-2105
Country	:	US
Telephone Number	:	440-995-6726
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2014
Last Update Date	:	10/23/2014

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Directions to “ MRS. DANIELLE KALLMEYER M.A. CCC/SLP” Practice Location

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