Healthcare Provider Details

I. General information

NPI: 1083135560
Provider Name (Legal Business Name): DANIELL E. CLINGMAN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2017
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23592 W WAYLAND DR
BUCKEYE AZ
85326-7245
US

IV. Provider business mailing address

23592 W WAYLAND DR
BUCKEYE AZ
85326-7245
US

V. Phone/Fax

Practice location:
  • Phone: 602-684-7400
  • Fax: 602-279-1431
Mailing address:
  • Phone: 602-684-7400
  • Fax: 602-279-1431

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code385HR2055X
TaxonomyChild Mental Illness Respite Care
License Number8594937
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253J00000X
TaxonomyFoster Care Agency
License Number8594937
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: