Provider Demographics
NPI:1023364668
Name:FALESNIK, DANIELLE FAYE (MS)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:FAYE
Last Name:FALESNIK
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:306 N STATE ST
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-4647
Mailing Address - Country:US
Mailing Address - Phone:920-795-7188
Mailing Address - Fax:920-570-6994
Practice Address - Street 1:601 1/2 W COLLEGE AVE STE 3
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-5818
Practice Address - Country:US
Practice Address - Phone:920-795-7188
Practice Address - Fax:920-570-6994
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-01
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5239-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty