Provider Demographics
NPI:1417396045
Name:AMERSON, DANYELLE (BS ED AND BHRS)
Entity Type:Individual
Prefix:
First Name:DANYELLE
Middle Name:
Last Name:AMERSON
Suffix:
Gender:F
Credentials:BS ED AND BHRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9211 N COUNCIL RD
Mailing Address - Street 2:APT 701
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-1345
Mailing Address - Country:US
Mailing Address - Phone:405-367-7700
Mailing Address - Fax:
Practice Address - Street 1:9211 N COUNCIL RD
Practice Address - Street 2:APT 701
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-1345
Practice Address - Country:US
Practice Address - Phone:405-367-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-17
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health