Provider Demographics
NPI:1629432976
Name:NOVERINI, DANIELLE RAE (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RAE
Last Name:NOVERINI
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 ALFORD PARK DR
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53140-1929
Mailing Address - Country:US
Mailing Address - Phone:847-809-0442
Mailing Address - Fax:
Practice Address - Street 1:4009 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027
Practice Address - Country:US
Practice Address - Phone:713-529-4990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-12
Last Update Date:2021-09-09
Deactivation Date:2021-08-28
Deactivation Code:
Reactivation Date:2021-09-09
Provider Licenses
StateLicense IDTaxonomies
TX1352744225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist