Provider Demographics
NPI:1912496266
Name:DEBLASIO, DANIELLE (MA CCC-SLP)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DEBLASIO
Suffix:
Gender:F
Credentials:MA CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4221 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:NEW CASTLE
Mailing Address - State:PA
Mailing Address - Zip Code:16105-4419
Mailing Address - Country:US
Mailing Address - Phone:724-714-1363
Mailing Address - Fax:
Practice Address - Street 1:950 YOUNGSTOWN WARREN RD STE C
Practice Address - Street 2:
Practice Address - City:NILES
Practice Address - State:OH
Practice Address - Zip Code:44446-4626
Practice Address - Country:US
Practice Address - Phone:330-505-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-02
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSP.13543235Z00000X, 235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist