Provider Demographics
NPI:1750484788
Name:DANIEWICZ, TORY SHILLAIRE (MS)
Entity type:Individual
Prefix:MS
First Name:TORY
Middle Name:SHILLAIRE
Last Name:DANIEWICZ
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10103 N DIVISION ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1380
Mailing Address - Country:US
Mailing Address - Phone:509-467-1156
Mailing Address - Fax:509-468-0462
Practice Address - Street 1:10103 N DIVISION ST
Practice Address - Street 2:SUITE 109
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1380
Practice Address - Country:US
Practice Address - Phone:509-467-1156
Practice Address - Fax:509-468-0462
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00008023101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health