Provider Demographics
NPI:1598368029
Name:SPINELLA, DANIELLE FRANCES (DPT)
Entity Type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:FRANCES
Last Name:SPINELLA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 PALM ST APT 5
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04401-4084
Mailing Address - Country:US
Mailing Address - Phone:203-917-5022
Mailing Address - Fax:
Practice Address - Street 1:103 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-4324
Practice Address - Country:US
Practice Address - Phone:207-947-4557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-18
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPT5828225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist