Provider Demographics
NPI:1083480305
Name:TOMAN, DANIELLE R (LPC-IT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:R
Last Name:TOMAN
Suffix:
Gender:F
Credentials:LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 68
Mailing Address - Street 2:
Mailing Address - City:MENOMONIE
Mailing Address - State:WI
Mailing Address - Zip Code:54751-0068
Mailing Address - Country:US
Mailing Address - Phone:715-635-4858
Mailing Address - Fax:
Practice Address - Street 1:4605 LONDON RD STE C
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-9183
Practice Address - Country:US
Practice Address - Phone:715-861-5427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-28
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7695-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional