Provider Demographics
NPI:1861694382
Name:POWERS, DANIELLE MARIE (PT)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:MARIE
Last Name:POWERS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:REEVES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:330 TURNER ROAD
Mailing Address - Street 2:
Mailing Address - City:MORRISONVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12962-2426
Mailing Address - Country:US
Mailing Address - Phone:518-643-2188
Mailing Address - Fax:
Practice Address - Street 1:133 MARGARET ST
Practice Address - Street 2:HEALTH DEPT HOME HEALTH CARE AGENCY
Practice Address - City:PLATTSBURGH
Practice Address - State:NY
Practice Address - Zip Code:12901
Practice Address - Country:US
Practice Address - Phone:518-565-3270
Practice Address - Fax:518-563-4586
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0186161225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
840890OtherACN GROUP