Individual
DANIELLE KIRTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
Mailing address
808 MILL LAKE RD, FORT WAYNE, IN 46845-6400
(260) 338-1241
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
22004206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200682180
FIRST STEPS
IN
Enumeration date
04/30/2008
Last updated
04/30/2008
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