Basic Information
| Provider Information | |||||||||
| NPI: | 1144327552 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SMARRELLA | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | M. | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2315 SUNSET BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402667006 | ||||||||
| FaxNumber: | 7402667049 | ||||||||
| Practice Location | |||||||||
| Address1: | 2315 SUNSET BLVD STE A | ||||||||
| Address2: | |||||||||
| City: | STEUBENVILLE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 439522496 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7402667006 | ||||||||
| FaxNumber: | 7402667049 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/20/2006 | ||||||||
| LastUpdateDate: | 05/11/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/11/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | AT005991 | PA | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | A.01420 | OH | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 0154456 | 05 | OH | MEDICAID | 1144327552 | 05 | WV | MEDICAID |