Provider Demographics
NPI:1467839837
Name:DONOFRIO, DANIELLE (MS ED)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:DONOFRIO
Suffix:
Gender:F
Credentials:MS ED
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DONOFRIO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:195 N OAK ST
Mailing Address - Street 2:
Mailing Address - City:MASSAPEQUA
Mailing Address - State:NY
Mailing Address - Zip Code:11758-3046
Mailing Address - Country:US
Mailing Address - Phone:516-698-5361
Mailing Address - Fax:516-213-3421
Practice Address - Street 1:195 N OAK ST
Practice Address - Street 2:
Practice Address - City:MASSAPEQUA
Practice Address - State:NY
Practice Address - Zip Code:11758-3046
Practice Address - Country:US
Practice Address - Phone:516-698-5361
Practice Address - Fax:516-213-3421
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-05
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool