Provider Demographics
NPI:1477026979
Name:SMITH, DANYELL S
Entity type:Individual
Prefix:MRS
First Name:DANYELL
Middle Name:S
Last Name:SMITH
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 1:7012 MOON CT
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46241-3665
Mailing Address - Country:US
Mailing Address - Phone:317-224-8882
Mailing Address - Fax:317-757-3637
Practice Address - Street 1:7012 MOON CT
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46241-3665
Practice Address - Country:US
Practice Address - Phone:317-224-8882
Practice Address - Fax:317-757-3637
Is Sole Proprietor?:No
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Q00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersDevelopmental Therapist