Individual
DANIELLE STAELEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 GOULD ST STE 290, NEEDHAM, MA 02494-2397
(781) 400-2605
Mailing address
55 OLD GREAT RD, NORTH SMITHFIELD, RI 02896-7716
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
77743
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
77743
MA SLP STATE LICENSE NUMBER
MA
Enumeration date
08/29/2022
Last updated
08/29/2022
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