Provider Demographics
NPI:1689145617
Name:ZAVALA, DANIELLE CAROL (MSW)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:CAROL
Last Name:ZAVALA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E MAIN ST STE 400
Mailing Address - Street 2:
Mailing Address - City:URBANA
Mailing Address - State:IL
Mailing Address - Zip Code:61801-2734
Mailing Address - Country:US
Mailing Address - Phone:217-954-8167
Mailing Address - Fax:
Practice Address - Street 1:102 E MAIN ST STE 400
Practice Address - Street 2:
Practice Address - City:URBANA
Practice Address - State:IL
Practice Address - Zip Code:61801-2734
Practice Address - Country:US
Practice Address - Phone:217-954-8167
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker