Provider Demographics
NPI:1821407321
Name:BARBER, DANYELLE
Entity Type:Individual
Prefix:
First Name:DANYELLE
Middle Name:
Last Name:BARBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:DANYELLE
Other - Middle Name:
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:725 E STATE ST
Mailing Address - Street 2:
Mailing Address - City:STERLING
Mailing Address - State:MI
Mailing Address - Zip Code:48659-9548
Mailing Address - Country:US
Mailing Address - Phone:989-654-2491
Mailing Address - Fax:989-654-2348
Practice Address - Street 1:725 E STATE ST
Practice Address - Street 2:
Practice Address - City:STERLING
Practice Address - State:MI
Practice Address - Zip Code:48659-9548
Practice Address - Country:US
Practice Address - Phone:989-654-2491
Practice Address - Fax:989-654-2348
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6802087991104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker