Provider Demographics
NPI:1770358970
Name:BARSKI, DANIELLE MARIE (LMT)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:MARIE
Last Name:BARSKI
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:908 3RD ST
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49203-3045
Mailing Address - Country:US
Mailing Address - Phone:734-834-1716
Mailing Address - Fax:
Practice Address - Street 1:100 W WASHINGTON AVE STE 102
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-2365
Practice Address - Country:US
Practice Address - Phone:734-219-9139
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-17
Last Update Date:2023-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI7501000294225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist