Provider Demographics
NPI:1700022183
Name:DANIELE, TARA DAWN (MSW)
Entity Type:Individual
Prefix:MISS
First Name:TARA
Middle Name:DAWN
Last Name:DANIELE
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:RR 2 BOX 2340
Mailing Address - Street 2:
Mailing Address - City:CANADENSIS
Mailing Address - State:PA
Mailing Address - Zip Code:18325-9710
Mailing Address - Country:US
Mailing Address - Phone:570-595-6055
Mailing Address - Fax:570-595-6013
Practice Address - Street 1:RR 2 BOX 2340
Practice Address - Street 2:
Practice Address - City:CANADENSIS
Practice Address - State:PA
Practice Address - Zip Code:18325-9710
Practice Address - Country:US
Practice Address - Phone:570-595-6055
Practice Address - Fax:570-595-6013
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-06
Last Update Date:2009-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker