Provider Demographics
NPI:1740351287
Name:LAJEUNESSE, DANIELLE LUCIE (DC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:LUCIE
Last Name:LAJEUNESSE
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10720 W INDIAN SCHOOL RD STE 67
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85037-5724
Mailing Address - Country:US
Mailing Address - Phone:623-877-0156
Mailing Address - Fax:623-877-4541
Practice Address - Street 1:10720 W INDIAN SCHOOL RD STE 67
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85037-5724
Practice Address - Country:US
Practice Address - Phone:623-877-0156
Practice Address - Fax:623-877-4541
Is Sole Proprietor?:No
Enumeration Date:2006-11-13
Last Update Date:2022-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7276111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZAZ0937460OtherBCBS
AZ10659982721OtherHUMANA
AZAW4523OtherHEALTHNET
AZAZ0937460OtherBCBS
AZ72082Medicare UPIN