Provider Demographics
NPI:1871880559
Name:WATERS, DANIELLE KRISTEN (MA, CCC-A, AUD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:KRISTEN
Last Name:WATERS
Suffix:
Gender:F
Credentials:MA, CCC-A, AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 N BELLEFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1458
Mailing Address - Country:US
Mailing Address - Phone:412-621-0100
Mailing Address - Fax:
Practice Address - Street 1:201 N BELLEFIELD AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15213-1458
Practice Address - Country:US
Practice Address - Phone:412-621-0100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-01
Last Update Date:2017-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAT001071-L231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist