Provider Demographics
NPI:1093514028
Name:GILL, DANIELLE (MS, CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:GILL
Suffix:
Gender:
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:BROOKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33016 AUDRAIN ROAD 744
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:65264-3407
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:101 S WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MEXICO
Practice Address - State:MO
Practice Address - Zip Code:65265-2730
Practice Address - Country:US
Practice Address - Phone:573-473-2394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-11
Last Update Date:2025-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist