Provider Demographics
NPI:1033343959
Name:CALLAHAN, DANIELLE (RMT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:CALLAHAN
Suffix:
Gender:F
Credentials:RMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2227 N WEBER ST
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80907-6946
Mailing Address - Country:US
Mailing Address - Phone:719-205-9808
Mailing Address - Fax:719-634-4538
Practice Address - Street 1:2227 N WEBER ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80907-6946
Practice Address - Country:US
Practice Address - Phone:719-205-9808
Practice Address - Fax:719-634-4538
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-06
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2442225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist