Provider Demographics
NPI:1427862937
Name:MCCORMICK, DANIELA ISABEL (SLPA)
Entity type:Individual
Prefix:
First Name:DANIELA
Middle Name:ISABEL
Last Name:MCCORMICK
Suffix:
Gender:F
Credentials:SLPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7713 S WINTER HAVEN CIR
Mailing Address - Street 2:
Mailing Address - City:MOHAVE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:86440-9011
Mailing Address - Country:US
Mailing Address - Phone:702-788-6950
Mailing Address - Fax:
Practice Address - Street 1:7713 S WINTER HAVEN CIR
Practice Address - Street 2:
Practice Address - City:MOHAVE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:86440-9011
Practice Address - Country:US
Practice Address - Phone:702-788-6950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZSLPA159432355S0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2355S0801XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistSpeech-Language Assistant