Provider Demographics
NPI:1467795567
Name:GOSSETT, DANEL
Entity Type:Individual
Prefix:
First Name:DANEL
Middle Name:
Last Name:GOSSETT
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 1:1702 SHERRI DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-8700
Mailing Address - Country:US
Mailing Address - Phone:606-271-2478
Mailing Address - Fax:606-802-2219
Practice Address - Street 1:1702 SHERRI DR
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-8700
Practice Address - Country:US
Practice Address - Phone:606-677-1166
Practice Address - Fax:606-677-0693
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-27
Last Update Date:2021-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY222Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist