Provider Demographics
NPI:1770906968
Name:HUPP, DANELLE (PHD)
Entity type:Individual
Prefix:
First Name:DANELLE
Middle Name:
Last Name:HUPP
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20800 WESTGATE MALL
Mailing Address - Street 2:SUITE 200
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-1323
Mailing Address - Country:US
Mailing Address - Phone:440-333-4949
Mailing Address - Fax:440-333-5044
Practice Address - Street 1:20800 WESTGATE MALL
Practice Address - Street 2:SUITE 200
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-1323
Practice Address - Country:US
Practice Address - Phone:440-333-4949
Practice Address - Fax:440-333-5044
Is Sole Proprietor?:No
Enumeration Date:2014-01-24
Last Update Date:2014-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH7099103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical