Provider Demographics
NPI:1962291849
Name:DRISCOLL, DAYNA MARIE (CPRS)
Entity type:Individual
Prefix:
First Name:DAYNA
Middle Name:MARIE
Last Name:DRISCOLL
Suffix:
Gender:
Credentials:CPRS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 KENWOOD LN
Mailing Address - Street 2:
Mailing Address - City:FLORHAM PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07932-2307
Mailing Address - Country:US
Mailing Address - Phone:973-219-0928
Mailing Address - Fax:
Practice Address - Street 1:5 KENWOOD LN
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2307
Practice Address - Country:US
Practice Address - Phone:973-219-0928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-06
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJCPRS-50101405300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes405300000XOther Service ProvidersPrevention Professional