Provider Demographics
NPI:1104599273
Name:JORGENSON, DANIELLE ALAINA (AUD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:ALAINA
Last Name:JORGENSON
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:720 W 34TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-1202
Mailing Address - Country:US
Mailing Address - Phone:512-346-7600
Mailing Address - Fax:512-346-7603
Practice Address - Street 1:720 W 34TH ST STE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1202
Practice Address - Country:US
Practice Address - Phone:512-346-7600
Practice Address - Fax:512-346-7603
Is Sole Proprietor?:No
Enumeration Date:2021-07-26
Last Update Date:2022-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81451231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist