Provider Demographics
NPI:1447955091
Name:DICKSON, DANIELLE L (SLP)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:L
Last Name:DICKSON
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:SCHAUGAARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SLP
Mailing Address - Street 1:9508 GRIFFIN RD
Mailing Address - Street 2:
Mailing Address - City:COOPER CITY
Mailing Address - State:FL
Mailing Address - Zip Code:33328-3416
Mailing Address - Country:US
Mailing Address - Phone:954-689-0730
Mailing Address - Fax:888-725-9013
Practice Address - Street 1:9508 GRIFFIN RD
Practice Address - Street 2:
Practice Address - City:COOPER CITY
Practice Address - State:FL
Practice Address - Zip Code:33328-3416
Practice Address - Country:US
Practice Address - Phone:954-689-0730
Practice Address - Fax:888-725-9013
Is Sole Proprietor?:No
Enumeration Date:2023-04-03
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSA18365235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist