Provider Demographics
NPI:1659480374
Name:CLADIS, DANIELLE RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:RENEE
Last Name:CLADIS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:RENEE
Other - Last Name:MOLLETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6204 LIONS PT
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80124-9527
Mailing Address - Country:US
Mailing Address - Phone:702-371-6880
Mailing Address - Fax:
Practice Address - Street 1:6204 LIONS PT
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80124-9527
Practice Address - Country:US
Practice Address - Phone:702-371-6880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2022-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COPTL.0016936225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1685OtherLICENSE