Provider Demographics
NPI:1255196044
Name:MAFFEI, DANIELLA PILAR (LSW)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:PILAR
Last Name:MAFFEI
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WOODPORT RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:SPARTA
Mailing Address - State:NJ
Mailing Address - Zip Code:07871-2415
Mailing Address - Country:US
Mailing Address - Phone:973-991-7202
Mailing Address - Fax:
Practice Address - Street 1:17 WOODPORT RD STE 2A
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NJ
Practice Address - Zip Code:07871-2415
Practice Address - Country:US
Practice Address - Phone:973-991-7202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07081400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker