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Individual

MS. DENISE M. DANCULL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
SLP

Contact information

Practice address
807 CHILDRENS WAY, JACKSONVILLE, FL 32207-8426
(904) 390-3690
(904) 858-3885
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA8106
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
419704492A
GA
05
890751000
FL
Enumeration date
08/10/2006
Last updated
09/12/2011
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