Provider Demographics
NPI:1124781745
Name:KWAKYE, DAISY
Entity type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:KWAKYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 DELTA CT
Mailing Address - Street 2:
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1352
Mailing Address - Country:US
Mailing Address - Phone:732-609-6523
Mailing Address - Fax:
Practice Address - Street 1:666 PLAINSBORO RD STE 2000C
Practice Address - Street 2:
Practice Address - City:PLAINSBORO
Practice Address - State:NJ
Practice Address - Zip Code:08536-3048
Practice Address - Country:US
Practice Address - Phone:844-234-8387
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-20
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ41YS01092000235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist