Provider Demographics
NPI:1093361578
Name:MARRIS, DANIELLE ELISE (PT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELISE
Last Name:MARRIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 HOSPITAL CENTER CMNS
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29926-2837
Mailing Address - Country:US
Mailing Address - Phone:436-892-2338
Mailing Address - Fax:843-689-2234
Practice Address - Street 1:39 HOSPITAL CENTER CMNS
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29926-2837
Practice Address - Country:US
Practice Address - Phone:436-892-2338
Practice Address - Fax:843-689-2234
Is Sole Proprietor?:No
Enumeration Date:2019-08-12
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9742225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist