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NPI Code Detail

MEDICARE: DANEYELLE ELDER MT-BC

MEDICARE: DANEYELLE ELDER MT-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225A00000XMusic Therapist

General Provider Information

NPI Number : 1629628128
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANEYELLE ELDER MT-BC
Provider Business Mailing Address
First Line : 6917 MARLOWE RD APT 806
Second Line :
City : RICHMOND
State : VA
Zip : 23225-4383
Country : US
Telephone Number : 804-466-3130
Fax Number :
Provider Business Practice Location Address
First Line : 830 SOUTHLAKE BLVD STE B
Second Line :
City : NORTH CHESTERFIELD
State : VA
Zip : 23236-3935
Country : US
Telephone Number : 804-466-3130
Fax Number : 804-466-3130
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2019
Last Update Date : 03/11/2022

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Directions to “ DANEYELLE ELDER MT-BC” Practice Location

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