Provider Demographics
NPI:1730702440
Name:DANIEL, SALOME MARIAM (SLP)
Entity type:Individual
Prefix:
First Name:SALOME
Middle Name:MARIAM
Last Name:DANIEL
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-3750
Mailing Address - Country:US
Mailing Address - Phone:281-245-3201
Mailing Address - Fax:
Practice Address - Street 1:2225 KINGSLEY DR
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-3750
Practice Address - Country:US
Practice Address - Phone:281-245-3201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-28
Last Update Date:2022-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX112259235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language PathologistGroup - Multi-Specialty