Provider Demographics
NPI:1912255407
Name:SECOR, DANNY ALLEN (AUD)
Entity type:Individual
Prefix:MR
First Name:DANNY
Middle Name:ALLEN
Last Name:SECOR
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:52 HCOS/SGGP
Mailing Address - Street 2:UNIT 3865
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09123-3690
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:52 HCOS/ SGGP
Practice Address - Street 2:UNIT 3865
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09123-3690
Practice Address - Country:US
Practice Address - Phone:314-452-8238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-15
Last Update Date:2022-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
UT8702615-4101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program