Provider Demographics
NPI:1205813789
Name:BARLOW, DANIELLE (PT)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:BARLOW
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:MOSHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSPT
Mailing Address - Street 1:10 LAKE STREET
Mailing Address - Street 2:
Mailing Address - City:ONANOCK
Mailing Address - State:VA
Mailing Address - Zip Code:23417
Mailing Address - Country:US
Mailing Address - Phone:757-709-0207
Mailing Address - Fax:252-353-5610
Practice Address - Street 1:26181 PARKSLEY ROAD
Practice Address - Street 2:
Practice Address - City:PARKSLEY
Practice Address - State:VA
Practice Address - Zip Code:23421
Practice Address - Country:US
Practice Address - Phone:757-665-5133
Practice Address - Fax:252-353-5610
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP19443225100000X
VA2305202352225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA278179OtherANTHEM BCBS
VA010031885Medicaid
VA010031885Medicaid