Healthcare Provider Details

I. General information

NPI: 1912813486
Provider Name (Legal Business Name): DANIELLE SALMON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4111 E VALLEY AUTO DR STE 106
MESA AZ
85206-4607
US

IV. Provider business mailing address

14216 N IBSEN DR APT A
FOUNTAIN HILLS AZ
85268-2089
US

V. Phone/Fax

Practice location:
  • Phone: 602-435-4356
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLAMFT-08166T
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: