Provider Demographics
NPI:1265743389
Name:FOGLIA, DANIELLE MARIANNE
Entity type:Individual
Prefix:MISS
First Name:DANIELLE
Middle Name:MARIANNE
Last Name:FOGLIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ENDICOTT AVE
Mailing Address - Street 2:
Mailing Address - City:REVERE
Mailing Address - State:MA
Mailing Address - Zip Code:02151-4156
Mailing Address - Country:US
Mailing Address - Phone:781-895-3200
Mailing Address - Fax:
Practice Address - Street 1:16 ENDICOTT AVE
Practice Address - Street 2:
Practice Address - City:REVERE
Practice Address - State:MA
Practice Address - Zip Code:02151-4156
Practice Address - Country:US
Practice Address - Phone:781-895-3200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2010-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst