Provider Demographics
NPI:1649057910
Name:ROYO, DANIELLE
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:ROYO
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:PO BOX 733
Mailing Address - Street 2:
Mailing Address - City:BELTSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20704-0733
Mailing Address - Country:US
Mailing Address - Phone:434-713-4033
Mailing Address - Fax:
Practice Address - Street 1:4600 POWDER MILL RD STE 450-K
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-2675
Practice Address - Country:US
Practice Address - Phone:301-918-5349
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD233011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD8006334227Medicaid