Provider Demographics
NPI:1346137858
Name:MCSHINE HENRY, DANIELLE J
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:J
Last Name:MCSHINE HENRY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:358 SOFIA LN
Mailing Address - Street 2:
Mailing Address - City:LAKE ALFRED
Mailing Address - State:FL
Mailing Address - Zip Code:33850-2560
Mailing Address - Country:US
Mailing Address - Phone:347-500-1986
Mailing Address - Fax:
Practice Address - Street 1:358 SOFIA LN
Practice Address - Street 2:
Practice Address - City:LAKE ALFRED
Practice Address - State:FL
Practice Address - Zip Code:33850-2560
Practice Address - Country:US
Practice Address - Phone:347-500-1986
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-18
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL222Q00000X
222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist