Provider Demographics
NPI:1346655594
Name:KEIPER, DANIELLE (PSYD)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:KEIPER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5900 BIS RD SW
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:OH
Mailing Address - Zip Code:43130-9606
Mailing Address - Country:US
Mailing Address - Phone:740-653-4324
Mailing Address - Fax:
Practice Address - Street 1:5900 BIS RD SW
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:OH
Practice Address - Zip Code:43130-9606
Practice Address - Country:US
Practice Address - Phone:740-653-4324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH6978103TC0700X
MI6301015388103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical