Provider Demographics
NPI:1225317167
Name:RONNER, DANIELLE (LAC)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:RONNER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:HENNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:1422 N. HANCOCK AVE
Mailing Address - Street 2:SUITE 5S
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80903
Mailing Address - Country:US
Mailing Address - Phone:719-520-5056
Mailing Address - Fax:
Practice Address - Street 1:1422 N. HANCOCK AVE
Practice Address - Street 2:SUITE 5S
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80903
Practice Address - Country:US
Practice Address - Phone:719-520-5056
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-09
Last Update Date:2023-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA13490171100000X
CO1659171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist