Provider Demographics
NPI:1487089900
Name:PETTY, DANIELLE BROOKE (RRT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:BROOKE
Last Name:PETTY
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 N ARIZONA AVE
Mailing Address - Street 2:#2009
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-1205
Mailing Address - Country:US
Mailing Address - Phone:480-737-6426
Mailing Address - Fax:
Practice Address - Street 1:2400 N ARIZONA AVE
Practice Address - Street 2:#2009
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-1205
Practice Address - Country:US
Practice Address - Phone:480-737-6426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ008743227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered