Healthcare Provider Details

I. General information

NPI: 1801498977
Provider Name (Legal Business Name): DANIELLE NOEL WINKELEER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/12/2020
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2244 S AVENUE A STE E
YUMA AZ
85364-8341
US

IV. Provider business mailing address

1185 E 26TH PL
YUMA AZ
85365-2927
US

V. Phone/Fax

Practice location:
  • Phone: 928-782-5588
  • Fax:
Mailing address:
  • Phone: 845-754-1148
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number32236
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number010761
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: