Provider Demographics
NPI:1831914795
Name:PACE, DANIELLE (LMT, MMP)
Entity type:Individual
Prefix:MS
First Name:DANIELLE
Middle Name:
Last Name:PACE
Suffix:
Gender:F
Credentials:LMT, MMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 N ORCHARD RD
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08360-3402
Mailing Address - Country:US
Mailing Address - Phone:856-305-3006
Mailing Address - Fax:
Practice Address - Street 1:80 N ORCHARD RD
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-3402
Practice Address - Country:US
Practice Address - Phone:856-305-3006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-16
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ18KT00273500225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist