Provider Demographics
NPI:1033693296
Name:SQUIRES, DANIELLE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:SQUIRES
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:ROSE
Other - Last Name:BEATINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:26 N 4TH ST
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-3575
Mailing Address - Country:US
Mailing Address - Phone:201-321-4752
Mailing Address - Fax:
Practice Address - Street 1:175 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MACUNGIE
Practice Address - State:PA
Practice Address - Zip Code:18062-1166
Practice Address - Country:US
Practice Address - Phone:610-966-6773
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-23
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT029203225100000X
NJ40QA01803600225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPT029203OtherPHYSICAL THERAPY BOARD OF PENNSYLVANIA