Basic Information
Provider Information
NPI: 1447869359
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMLIN
FirstName: DANEILLE
MiddleName: BARBARA
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4629 RIVER RUN LN
Address2:  
City: ROUGEMONT
State: NC
PostalCode: 275728498
CountryCode: US
TelephoneNumber: 7162509568
FaxNumber:  
Practice Location
Address1: 4420 LAKE BOONE TRL
Address2:  
City: RALEIGH
State: NC
PostalCode: 276077505
CountryCode: US
TelephoneNumber: 9197843100
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/27/2020
LastUpdateDate: 07/27/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/27/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000X  Y Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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