Basic Information
| Provider Information | |||||||||
| NPI: | 1467619585 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DIGREGORIO | ||||||||
| FirstName: | DANIELLE | ||||||||
| MiddleName: | T. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PSY.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 39 CLAYBURGH RD | ||||||||
| Address2: | |||||||||
| City: | THORNTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 193731103 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6102990192 | ||||||||
| FaxNumber: | 6103991688 | ||||||||
| Practice Location | |||||||||
| Address1: | 42 E LAUREL RD | ||||||||
| Address2: | UPD#1800 | ||||||||
| City: | STRATFORD | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 080841354 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8565666843 | ||||||||
| FaxNumber: | 8565666419 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2008 | ||||||||
| LastUpdateDate: | 08/08/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103G00000X | PS016425 | PA | N | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103T00000X | PS016425 | PA | N | Behavioral Health & Social Service Providers | Psychologist | 103G00000X | 121-007 | NJ | Y | Behavioral Health & Social Service Providers | Clinical Neuropsychologist | 103T00000X | 121-007 | NJ | N | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.