Provider Demographics
NPI:1629628128
Name:ELDER, DANEYELLE (MT-BC)
Entity Type:Individual
Prefix:
First Name:DANEYELLE
Middle Name:
Last Name:ELDER
Suffix:
Gender:F
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6917 MARLOWE RD APT 806
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4383
Mailing Address - Country:US
Mailing Address - Phone:804-466-3130
Mailing Address - Fax:
Practice Address - Street 1:830 SOUTHLAKE BLVD STE B
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3935
Practice Address - Country:US
Practice Address - Phone:804-466-3130
Practice Address - Fax:804-466-3130
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic Therapist