Individual
DANIELLE SHORT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12319 HIGHLAND RD STE 501, HARTLAND, MI 48353-2946
(810) 991-1211
Mailing address
212 BRIGHTON LAKE RD, BRIGHTON, MI 48116-1722
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
7101004769
MI
Other
Enumeration date
01/29/2017
Last updated
01/29/2017
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