Provider Demographics
NPI:1467749952
Name:CHAMBLEE, DANIELLE C (OTR)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:C
Last Name:CHAMBLEE
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:199 TEXAS GAS LN
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:KY
Mailing Address - Zip Code:42025-6688
Mailing Address - Country:US
Mailing Address - Phone:501-827-9499
Mailing Address - Fax:
Practice Address - Street 1:199 TEXAS GAS LN
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:KY
Practice Address - Zip Code:42025-6688
Practice Address - Country:US
Practice Address - Phone:150-182-7949
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-05
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY286953225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist