Individual
DANIELLE SCULLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1330 W 26TH ST, ERIE, PA 16508-1402
(814) 459-9300
Mailing address
4115 MELROSE AVE, ERIE, PA 16509-1219
(716) 969-0930
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SL011828
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
SL011828
PA STATE LICENSE
PA
Enumeration date
08/15/2016
Last updated
08/15/2016
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