Provider Demographics
NPI:1831396522
Name:MIDDLETON, DENISE M (MS, CCC)
Entity type:Individual
Prefix:MRS
First Name:DENISE
Middle Name:M
Last Name:MIDDLETON
Suffix:
Gender:F
Credentials:MS, CCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 WHITING WOODS RD
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91208-1048
Mailing Address - Country:US
Mailing Address - Phone:818-541-6836
Mailing Address - Fax:818-783-6176
Practice Address - Street 1:531 WHITING WOODS RD
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91208-1048
Practice Address - Country:US
Practice Address - Phone:818-541-6836
Practice Address - Fax:818-783-6176
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA6646235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist