Provider Demographics
NPI:1427383488
Name:MARYOTT, DANIELLE
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:MARYOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:MARIE
Other - Last Name:DIXON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 DEEPWOOD ROAD
Mailing Address - Street 2:
Mailing Address - City:EASTON
Mailing Address - State:CT
Mailing Address - Zip Code:06612
Mailing Address - Country:US
Mailing Address - Phone:203-979-0858
Mailing Address - Fax:203-629-2940
Practice Address - Street 1:755 MAIN STREET NO. 8 SUITE B
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:CT
Practice Address - Zip Code:06468
Practice Address - Country:US
Practice Address - Phone:203-629-2822
Practice Address - Fax:203-629-2940
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-08
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical