Provider Demographics
NPI:1598099160
Name:COSSIN, DANIELLE JEANNE (DC)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:JEANNE
Last Name:COSSIN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:652 SW PAAR DR
Mailing Address - Street 2:
Mailing Address - City:PORT ST LUCIE
Mailing Address - State:FL
Mailing Address - Zip Code:34953-3903
Mailing Address - Country:US
Mailing Address - Phone:772-579-6201
Mailing Address - Fax:
Practice Address - Street 1:787 E PRIMA VISTA BLVD STE A
Practice Address - Street 2:
Practice Address - City:PORT ST LUCIE
Practice Address - State:FL
Practice Address - Zip Code:34952-2201
Practice Address - Country:US
Practice Address - Phone:772-579-6201
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH8663111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor