Provider Demographics
NPI:1225463672
Name:RYDER, DANIELLE LARAY
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:LARAY
Last Name:RYDER
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:LARAY
Other - Last Name:HESS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2965 OLD SAMS CREEK RD
Mailing Address - Street 2:
Mailing Address - City:PEGRAM
Mailing Address - State:TN
Mailing Address - Zip Code:37143-6000
Mailing Address - Country:US
Mailing Address - Phone:615-352-4392
Mailing Address - Fax:
Practice Address - Street 1:2965 OLD SAMS CREEK RD
Practice Address - Street 2:
Practice Address - City:PEGRAM
Practice Address - State:TN
Practice Address - Zip Code:37143-6000
Practice Address - Country:US
Practice Address - Phone:615-352-4392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health