Provider Demographics
NPI:1578021564
Name:DANIELS, DANIELLE (COTA/L)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:DANIELS
Suffix:
Gender:F
Credentials:COTA/L
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:GRIGIONI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:COTA/L
Mailing Address - Street 1:901 ARCOLA AVE
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20902-3401
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:901 ARCOLA AVE
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20902-3401
Practice Address - Country:US
Practice Address - Phone:301-649-2400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA02590224Z00000X
VA0131002502224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDA02590OtherMD STATE LICENSE FOR OTA