Provider Demographics
NPI:1316174196
Name:GREGORY, DANIELLE RENEE (MS, CCC-SLP)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RENEE
Last Name:GREGORY
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:RENEE
Other - Last Name:HUBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, CCC-SLP
Mailing Address - Street 1:501 1/2 WALTON ST
Mailing Address - Street 2:
Mailing Address - City:PHILIPSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16866-2533
Mailing Address - Country:US
Mailing Address - Phone:814-343-6143
Mailing Address - Fax:
Practice Address - Street 1:501 1/2 WALTON ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:PA
Practice Address - Zip Code:16866-2533
Practice Address - Country:US
Practice Address - Phone:814-343-6143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASL009474235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist