Provider Demographics
NPI:1003120593
Name:KOONTZ, DANIELLE WINNER (MAA, CBE)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:WINNER
Last Name:KOONTZ
Suffix:
Gender:F
Credentials:MAA, CBE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 PAYSON AVE
Mailing Address - Street 2:
Mailing Address - City:CATONSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21228-5115
Mailing Address - Country:US
Mailing Address - Phone:410-719-0394
Mailing Address - Fax:
Practice Address - Street 1:5 PAYSON AVE
Practice Address - Street 2:
Practice Address - City:CATONSVILLE
Practice Address - State:MD
Practice Address - Zip Code:21228-5115
Practice Address - Country:US
Practice Address - Phone:410-719-0394
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-27
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula