Provider Demographics
NPI:1891730701
Name:MOFFIT, DANI MICHELLE (MA, ATC)
Entity Type:Individual
Prefix:
First Name:DANI
Middle Name:MICHELLE
Last Name:MOFFIT
Suffix:
Gender:F
Credentials:MA, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:103 EDISON AVE
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-3124
Mailing Address - Country:US
Mailing Address - Phone:856-854-5998
Mailing Address - Fax:
Practice Address - Street 1:103 EDISON AVE
Practice Address - Street 2:
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-3124
Practice Address - Country:US
Practice Address - Phone:856-854-5998
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer