Provider Demographics
NPI:1982258307
Name:PINARD, DANIELLE
Entity Type:Individual
Prefix:
First Name:DANIELLE
Middle Name:
Last Name:PINARD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:293 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:CANDIA
Mailing Address - State:NH
Mailing Address - Zip Code:03034-2717
Mailing Address - Country:US
Mailing Address - Phone:603-848-8388
Mailing Address - Fax:
Practice Address - Street 1:293 HIGH ST
Practice Address - Street 2:
Practice Address - City:CANDIA
Practice Address - State:NH
Practice Address - Zip Code:03034-2717
Practice Address - Country:US
Practice Address - Phone:603-848-8388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RBT-17-34440106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL020605800Medicaid