Provider Demographics
NPI:1962885442
Name:BREITBART, DANIELLE (AUD)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:BREITBART
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1629 COLUMBIA RD NW
Mailing Address - Street 2:APT 426
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-3662
Mailing Address - Country:US
Mailing Address - Phone:954-610-7539
Mailing Address - Fax:
Practice Address - Street 1:1629 COLUMBIA RD NW
Practice Address - Street 2:APT 426
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-3662
Practice Address - Country:US
Practice Address - Phone:954-610-7539
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT94249084101231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist