Basic Information
| Provider Information | |||||||||
| NPI: | 1639783269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORTHRUP | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 129 S DRAKE RD | ||||||||
| Address2: | |||||||||
| City: | KALAMAZOO | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490091107 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2692714180 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1555 44TH ST SW | ||||||||
| Address2: | |||||||||
| City: | WYOMING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 495094313 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6162498000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/01/2020 | ||||||||
| LastUpdateDate: | 09/01/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 09/01/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 1601000899 | MI | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.