Healthcare Provider Details

I. General information

NPI: 1346535747
Provider Name (Legal Business Name): MS. DANIELLE MARIE FLINT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2011
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 MARKET ST FL 2
LYNN MA
01901-1125
US

IV. Provider business mailing address

112 MARKET ST FL 2
LYNN MA
01901-1125
US

V. Phone/Fax

Practice location:
  • Phone: 781-593-7676
  • Fax: 781-595-1081
Mailing address:
  • Phone: 781-593-7676
  • Fax: 781-595-1081

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: