Provider Demographics
NPI:1841431947
Name:CHASE, DANIELLE (PHD)
Entity Type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:CHASE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:MS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DILKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS
Mailing Address - Street 1:616 MAGILL AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08107-2321
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 LAUREL OAK RD
Practice Address - Street 2:E-2
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-3512
Practice Address - Country:US
Practice Address - Phone:856-346-0005
Practice Address - Fax:856-784-1799
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00462600103G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist