Provider Demographics
NPI:1780220236
Name:EGLIN, DANIELLE EILEEN (CMT)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:EILEEN
Last Name:EGLIN
Suffix:
Gender:F
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5125 WARING RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92120-2705
Mailing Address - Country:US
Mailing Address - Phone:619-431-5407
Mailing Address - Fax:
Practice Address - Street 1:5125 WARING RD
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92120-2705
Practice Address - Country:US
Practice Address - Phone:619-431-5407
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist