Healthcare Provider Details

I. General information

NPI: 1487416152
Provider Name (Legal Business Name): DANIELLE LYNNEA MCDUFFIE USOROH PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2024
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 BENSON RD
GARNER NC
27529-9059
US

IV. Provider business mailing address

100 STRATFORD LAKES DR UNIT 208
DURHAM NC
27713-3479
US

V. Phone/Fax

Practice location:
  • Phone: 919-286-0411
  • Fax:
Mailing address:
  • Phone: 908-380-4662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number6637
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: