Individual
MRS. DANIELLE YAMILE DEWAILLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
2204 NATHAN DR, AUSTIN, TX 78728-4515
(512) 284-8386
Mailing address
2204 NATHAN DR, AUSTIN, TX 78728-4515
(512) 284-8386
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211817
TX
235Z00000X
Speech-Language Pathologist
211817
TX
Other
Enumeration date
12/20/2014
Last updated
09/12/2018
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