Provider Demographics
NPI:1043395932
Name:DANIELS, ELEANOR GODDARD (CPM)
Entity Type:Individual
Prefix:
First Name:ELEANOR
Middle Name:GODDARD
Last Name:DANIELS
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:355 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MONTVILLE
Mailing Address - State:ME
Mailing Address - Zip Code:04941-4504
Mailing Address - Country:US
Mailing Address - Phone:207-342-3060
Mailing Address - Fax:
Practice Address - Street 1:111 HIGH ST
Practice Address - Street 2:
Practice Address - City:BELFAST
Practice Address - State:ME
Practice Address - Zip Code:04915-6351
Practice Address - Country:US
Practice Address - Phone:207-338-0708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife