Provider Demographics
NPI:1649229824
Name:ARDITY, DANIELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:ARDITY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MELLIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:7852 NW 62ND TER
Mailing Address - Street 2:
Mailing Address - City:PARKLAND
Mailing Address - State:FL
Mailing Address - Zip Code:33067-3349
Mailing Address - Country:US
Mailing Address - Phone:954-296-5108
Mailing Address - Fax:954-796-3295
Practice Address - Street 1:940 E CYPRESS CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33334-4110
Practice Address - Country:US
Practice Address - Phone:954-296-5108
Practice Address - Fax:954-796-3295
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5853103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical