Provider Demographics
NPI:1629680392
Name:HALASZ, DANIELLE (OTR/L)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HALASZ
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:HICKEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:1661 RIVERSIDE AVE APT 320
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-4025
Mailing Address - Country:US
Mailing Address - Phone:904-566-7888
Mailing Address - Fax:
Practice Address - Street 1:1157 BEACH BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE BEACH
Practice Address - State:FL
Practice Address - Zip Code:32250-3445
Practice Address - Country:US
Practice Address - Phone:904-450-5061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-23
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL19468225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL19468OtherOCCUPATIONAL THERAPY LICENSE NUMBER