Provider Demographics
NPI:1750936316
Name:NAKUTIS, DANIELLE MIA BELZER (MA)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MIA BELZER
Last Name:NAKUTIS
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 LAVENDER DR
Mailing Address - Street 2:
Mailing Address - City:ROMEOVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60446-5137
Mailing Address - Country:US
Mailing Address - Phone:913-963-1508
Mailing Address - Fax:
Practice Address - Street 1:1628 LAVENDER DR
Practice Address - Street 2:
Practice Address - City:ROMEOVILLE
Practice Address - State:IL
Practice Address - Zip Code:60446-5137
Practice Address - Country:US
Practice Address - Phone:913-963-1508
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL146.015400235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist