Individual
DANIELLE NICOLE WATERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MA CCC-SLP
Contact information
Practice address
4680 LAKE UNDERHILL RD, ORLANDO, FL 32807-1182
(407) 852-3300
Mailing address
4657 LAKE CALABAY DR, ORLANDO, FL 32837-5473
(407) 312-8411
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SA14022
FL
235Z00000X
Speech-Language Pathologist
SZ6765
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
012957700
—
FL
Enumeration date
08/18/2014
Last updated
08/31/2021
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