Provider Demographics
NPI:1790306025
Name:WINEGARDNER, DANIELLE ANNETTE (MS,QMHS)
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ANNETTE
Last Name:WINEGARDNER
Suffix:
Gender:F
Credentials:MS,QMHS
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:ANNETTE
Other - Last Name:SPIRES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, QMHS
Mailing Address - Street 1:2845 BELL ST
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1720
Mailing Address - Country:US
Mailing Address - Phone:740-454-9766
Mailing Address - Fax:740-588-6452
Practice Address - Street 1:121 N 18TH ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:OH
Practice Address - Zip Code:43725-2501
Practice Address - Country:US
Practice Address - Phone:740-432-5130
Practice Address - Fax:740-432-5345
Is Sole Proprietor?:No
Enumeration Date:2020-04-28
Last Update Date:2020-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0401670Medicaid