Provider Demographics
NPI:1467057950
Name:COMPTON, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2870 BUCK CREEK PL
Mailing Address - Street 2:
Mailing Address - City:GREEN CV SPGS
Mailing Address - State:FL
Mailing Address - Zip Code:32043-8628
Mailing Address - Country:US
Mailing Address - Phone:614-562-0459
Mailing Address - Fax:
Practice Address - Street 1:2870 BUCK CREEK PL
Practice Address - Street 2:
Practice Address - City:GREEN CV SPGS
Practice Address - State:FL
Practice Address - Zip Code:32043-8628
Practice Address - Country:US
Practice Address - Phone:614-562-0459
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRBT-20-136671106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician