Provider Demographics
NPI:1871351957
Name:CARTER, DANELLE
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:690 MISSOURI AVE STE 11
Mailing Address - Street 2:
Mailing Address - City:SAINT ROBERT
Mailing Address - State:MO
Mailing Address - Zip Code:65584-4680
Mailing Address - Country:US
Mailing Address - Phone:573-336-1970
Mailing Address - Fax:
Practice Address - Street 1:690 MISSOURI AVE STE 11
Practice Address - Street 2:
Practice Address - City:SAINT ROBERT
Practice Address - State:MO
Practice Address - Zip Code:65584-4680
Practice Address - Country:US
Practice Address - Phone:573-336-1970
Practice Address - Fax:573-232-1055
Is Sole Proprietor?:No
Enumeration Date:2024-03-12
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20190190712355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant