Provider Demographics
NPI:1225889025
Name:HEGDALE, DANIELLE (BA, MS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:HEGDALE
Suffix:
Gender:F
Credentials:BA, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1741 S PINE PL
Mailing Address - Street 2:
Mailing Address - City:BROKEN ARROW
Mailing Address - State:OK
Mailing Address - Zip Code:74012-5218
Mailing Address - Country:US
Mailing Address - Phone:918-906-7697
Mailing Address - Fax:
Practice Address - Street 1:1741 S PINE PL
Practice Address - Street 2:
Practice Address - City:BROKEN ARROW
Practice Address - State:OK
Practice Address - Zip Code:74012-5218
Practice Address - Country:US
Practice Address - Phone:918-906-7697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
No374J00000XNursing Service Related ProvidersDoula