Provider Demographics
NPI:1629551130
Name:CHAPPELL, DANIELLE RENE'
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:RENE'
Last Name:CHAPPELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17185 S 125TH ST E
Mailing Address - Street 2:
Mailing Address - City:WEBBERS FALLS
Mailing Address - State:OK
Mailing Address - Zip Code:74470-3208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:415 HIGHWAY 377 S STE 200
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-5140
Practice Address - Country:US
Practice Address - Phone:940-464-7010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2216225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant