Provider Demographics
NPI:1063177624
Name:ABDULLAH, DANIELLE SARRONE (LSW)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:SARRONE
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9247 N MERIDIAN ST STE 255
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-1879
Mailing Address - Country:US
Mailing Address - Phone:317-626-2595
Mailing Address - Fax:
Practice Address - Street 1:9247 N MERIDIAN ST STE 255
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1879
Practice Address - Country:US
Practice Address - Phone:317-626-2595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-08
Last Update Date:2021-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33009158A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker