Provider Demographics
NPI:1376770966
Name:GARRIS, DANIELLE L (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:L
Last Name:GARRIS
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:PA
Mailing Address - Zip Code:16701-3278
Mailing Address - Country:US
Mailing Address - Phone:814-817-1400
Mailing Address - Fax:814-362-2185
Practice Address - Street 1:800 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BRADFORD
Practice Address - State:PA
Practice Address - Zip Code:16701-3278
Practice Address - Country:US
Practice Address - Phone:814-817-1400
Practice Address - Fax:814-362-2185
Is Sole Proprietor?:No
Enumeration Date:2009-06-22
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS 016644103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical