Healthcare Provider Details

I. General information

NPI: 1982857801
Provider Name (Legal Business Name): DANIELLE MARIE ELDRIDGE MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. DANIELLE MARIE LYLE

II. Dates (important events)

Enumeration Date: 10/23/2008
Last Update Date: 10/23/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 S 25TH ST W
BILLINGS MT
59102-7417
US

IV. Provider business mailing address

1935 BELVEDERE DR
BILLINGS MT
59102-2718
US

V. Phone/Fax

Practice location:
  • Phone: 406-656-0928
  • Fax: 406-656-0935
Mailing address:
  • Phone: 406-254-0652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: