Basic Information
| Provider Information | |||||||||
| NPI: | 1851678551 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | DANNIELLE | ||||||||
| MiddleName: | MARIE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 895 ROBERTA LANE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894316810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753316252 | ||||||||
| FaxNumber: | 7753316250 | ||||||||
| Practice Location | |||||||||
| Address1: | 895 ROBERTA LANE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | SPARKS | ||||||||
| State: | NV | ||||||||
| PostalCode: | 894316810 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7753316252 | ||||||||
| FaxNumber: | 7753316250 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2011 | ||||||||
| LastUpdateDate: | 06/16/2015 | ||||||||
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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 | 225400000X | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner |
No ID Information.