Provider Demographics
NPI:1497498349
Name:DANIEL, FABIENNE
Entity Type:Individual
Prefix:MS
First Name:FABIENNE
Middle Name:
Last Name:DANIEL
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 1:4333 KUTZTOWN RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:PA
Mailing Address - Zip Code:19560-1838
Mailing Address - Country:US
Mailing Address - Phone:610-223-6456
Mailing Address - Fax:
Practice Address - Street 1:4333 KUTZTOWN RD
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:PA
Practice Address - Zip Code:19560-1838
Practice Address - Country:US
Practice Address - Phone:610-223-6456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-19
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174200000XOther Service ProvidersMeals
No332U00000XSuppliersHome Delivered Meals