Individual
DANIELLE M PETERSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.S., CCC-SLP
Contact information
Practice address
20402 N 15TH AVE, PHOENIX, AZ 85027-3636
(623) 445-4952
(623) 445-5083
Mailing address
20402 N 15TH AVE, PHOENIX, AZ 85027-3636
(623) 445-4952
(623) 445-5083
Taxonomy
Speciality
Code
Description
License number
State
2355S0801X
Speech-Language Assistant
SLPA7780
AZ
235Z00000X
Speech-Language Pathologist
Primary
SLP7780
AZ
Other
Enumeration date
08/09/2012
Last updated
05/06/2019
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