Provider Demographics
NPI:1851146609
Name:CARY, DANIELLE ALYSSA (CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ALYSSA
Last Name:CARY
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1714 BROADMORE CT
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7644
Mailing Address - Country:US
Mailing Address - Phone:607-644-8112
Mailing Address - Fax:
Practice Address - Street 1:154 AMENDMENT AVE STE 104
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-3156
Practice Address - Country:US
Practice Address - Phone:803-203-2864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-23
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSLP.8659235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist