Provider Demographics
NPI:1689213985
Name:TUOHY, DANIELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:TUOHY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:DR
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:KEENAN-MILLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:101 S KILKEA DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3525
Mailing Address - Country:US
Mailing Address - Phone:347-262-7005
Mailing Address - Fax:
Practice Address - Street 1:566 S SAN VICENTE BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-4650
Practice Address - Country:US
Practice Address - Phone:323-521-9079
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-03
Last Update Date:2020-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY24352103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical