Individual
DIEDRE DANIELS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
7330 FERN AVE STE 503, SHREVEPORT, LA 71105-4983
(866) 730-0707
Mailing address
2602 ZODIAC DR, GARLAND, TX 75044-6646
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
102615
TX
Other
Enumeration date
04/25/2007
Last updated
12/17/2021
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