Provider Demographics
NPI:1407253214
Name:SCANLON, DANIELLE LEE (CPM)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LEE
Last Name:SCANLON
Suffix:
Gender:F
Credentials:CPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:943 BELFAST RD
Mailing Address - Street 2:
Mailing Address - City:KNOX
Mailing Address - State:ME
Mailing Address - Zip Code:04986-4531
Mailing Address - Country:US
Mailing Address - Phone:207-568-4085
Mailing Address - Fax:
Practice Address - Street 1:943 BELFAST RD
Practice Address - Street 2:
Practice Address - City:KNOX
Practice Address - State:ME
Practice Address - Zip Code:04986-4531
Practice Address - Country:US
Practice Address - Phone:207-568-4085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-21
Last Update Date:2014-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife