Provider Demographics
NPI:1508016734
Name:SLATER, DANIELLE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:SLATER
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:KNIPPENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPT
Mailing Address - Street 1:1691 BETHLEHEM PIKE
Mailing Address - Street 2:
Mailing Address - City:HATFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19440-1302
Mailing Address - Country:US
Mailing Address - Phone:267-308-5330
Mailing Address - Fax:267-308-5331
Practice Address - Street 1:1691 BETHLEHEM PIKE
Practice Address - Street 2:
Practice Address - City:HATFIELD
Practice Address - State:PA
Practice Address - Zip Code:19440-1302
Practice Address - Country:US
Practice Address - Phone:267-308-5330
Practice Address - Fax:267-308-5331
Is Sole Proprietor?:No
Enumeration Date:2008-09-24
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT021666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1030043650001Medicaid