Provider Demographics
NPI:1730580176
Name:AUBUCHON, DANIELLE
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:AUBUCHON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6003 FIFTH STREET
Mailing Address - Street 2:
Mailing Address - City:KIMMSWICK
Mailing Address - State:MO
Mailing Address - Zip Code:63053
Mailing Address - Country:US
Mailing Address - Phone:636-464-4408
Mailing Address - Fax:
Practice Address - Street 1:6003 FIFTH STREET
Practice Address - Street 2:
Practice Address - City:KIMMSWICK
Practice Address - State:MO
Practice Address - Zip Code:63053
Practice Address - Country:US
Practice Address - Phone:636-464-4408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-04
Last Update Date:2014-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014021037235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist