Provider Demographics
NPI:1508197781
Name:TANNEHILL, DANIELLE MARIE (OTR/L)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:TANNEHILL
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1230 TAYLOR LANE EXT
Mailing Address - Street 2:SUITE 324
Mailing Address - City:LEHIGH ACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33936-6159
Mailing Address - Country:US
Mailing Address - Phone:239-303-0957
Mailing Address - Fax:239-303-2461
Practice Address - Street 1:1230 TAYLOR LANE EXT
Practice Address - Street 2:SUITE 324
Practice Address - City:LEHIGH ACRES
Practice Address - State:FL
Practice Address - Zip Code:33936-6159
Practice Address - Country:US
Practice Address - Phone:239-303-0957
Practice Address - Fax:239-303-2461
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10669225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLOT 10669OtherSTATE OF FLORIDA DEPARTMENT OF HEALTH