Individual
DANIELLE ETCHEVERRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 W EATON AVE, TRACY, CA 95376-3529
(209) 914-1663
Mailing address
14 W EATON AVE, TRACY, CA 95376-3529
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
21633
CA
Other
Enumeration date
12/22/2016
Last updated
12/22/2016
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