Provider Demographics
NPI:1164804340
Name:SHRANK, DANIELLE NICOLE (PSYS)
Entity Type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:NICOLE
Last Name:SHRANK
Suffix:
Gender:F
Credentials:PSYS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:366 PRESTWICK CIR APT 2
Mailing Address - Street 2:
Mailing Address - City:PALM BEACH GARDENS
Mailing Address - State:FL
Mailing Address - Zip Code:33418-8445
Mailing Address - Country:US
Mailing Address - Phone:561-389-3641
Mailing Address - Fax:561-389-3641
Practice Address - Street 1:366 PRESTWICK CIR APT 2
Practice Address - Street 2:
Practice Address - City:PALM BEACH GARDENS
Practice Address - State:FL
Practice Address - Zip Code:33418-8445
Practice Address - Country:US
Practice Address - Phone:561-389-3641
Practice Address - Fax:561-389-3641
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-23
Last Update Date:2015-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSS1139103TH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service