Provider Demographics
NPI:1205261401
Name:MUELLER, MEADE DANIELLE (LAC)
Entity type:Individual
Prefix:
First Name:MEADE
Middle Name:DANIELLE
Last Name:MUELLER
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10918 CALERA RD
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19154-3906
Mailing Address - Country:US
Mailing Address - Phone:267-265-8235
Mailing Address - Fax:
Practice Address - Street 1:10918 CALERA RD
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19154-3906
Practice Address - Country:US
Practice Address - Phone:267-265-8235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAAK001096171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist