Basic Information
| Provider Information | |||||||||
| NPI: | 1972899730 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | STARR | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | M | ||||||||
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| Credential: | AUD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6600 S YALE AVE STE 1200 | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741363361 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9184886045 | ||||||||
| FaxNumber: | 9184886098 | ||||||||
| Practice Location | |||||||||
| Address1: | 6475 S YALE AVE STE 401 | ||||||||
| Address2: | |||||||||
| City: | TULSA | ||||||||
| State: | OK | ||||||||
| PostalCode: | 741367818 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9185029555 | ||||||||
| FaxNumber: | 9185029559 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2011 | ||||||||
| LastUpdateDate: | 05/21/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/21/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 000742 | IA | N | Speech, Language and Hearing Service Providers | Audiologist | 231H00000X | 301 | NE | N | Speech, Language and Hearing Service Providers | Audiologist | 237600000X | 001036 | IA | N | Speech, Language and Hearing Service Providers | Audiologist-Hearing Aid Fitter | 237700000X | 121 | NE | N | Speech, Language and Hearing Service Providers | Hearing Instrument Specialist | 231H00000X | 4696 | OK | Y | Speech, Language and Hearing Service Providers | Audiologist |
ID Information
| ID | Type | State | Issuer | Description | 10025839400 | 05 | NE | MEDICAID | 1972899730 | 05 | IA | MEDICAID |