MEDICARE: MRS. DANYELLE E FELTS MED 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

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1528156296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. DANYELLE E FELTS MED CCC SLP

Provider Business Mailing Address
First Line	:	8300 SAWYER BROWN RD APT P303
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37221-7666
Country	:	US
Telephone Number	:	615-480-3289
Fax Number	:	615-673-2329

Provider Business Practice Location Address
First Line	:	301 WOLVERINE TRL
Second Line	:	SUITE 201
City	:	SMYRNA
State	:	TN
Zip	:	37167-5656
Country	:	US
Telephone Number	:	615-220-5796
Fax Number	:	615-220-8829

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	01/25/2012

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