Provider Demographics
NPI:1720512262
Name:DANIEL, DAHIFNA (MS)
Entity type:Individual
Prefix:MISS
First Name:DAHIFNA
Middle Name:
Last Name:DANIEL
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4705 W VILLAGE WAY SE
Mailing Address - Street 2:APT. #2520
Mailing Address - City:SMYRNA
Mailing Address - State:GA
Mailing Address - Zip Code:30080-9320
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2385 LAWRENCEVILLE HWY
Practice Address - Street 2:STE. B
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3168
Practice Address - Country:US
Practice Address - Phone:404-289-4270
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPCET002335235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist