Provider Demographics
NPI:1447709274
Name:HENRY, DANIELLE (AUD, CCC-A)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HENRY
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23251 I 30 SOUTH
Mailing Address - Street 2:
Mailing Address - City:BRYANT
Mailing Address - State:AR
Mailing Address - Zip Code:72022
Mailing Address - Country:US
Mailing Address - Phone:501-614-7904
Mailing Address - Fax:501-223-1733
Practice Address - Street 1:100 RIDGEWAY ST STE 8
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7156
Practice Address - Country:US
Practice Address - Phone:501-359-3113
Practice Address - Fax:501-359-3115
Is Sole Proprietor?:No
Enumeration Date:2016-09-21
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA419231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist