Healthcare Provider Details

I. General information

NPI: 1225815491
Provider Name (Legal Business Name): DANIELLE WILHELM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2023
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6513 TENNANT RD
BERLIN HEIGHTS OH
44814-9309
US

IV. Provider business mailing address

6513 TENNANT RD
BERLIN HEIGHTS OH
44814-9309
US

V. Phone/Fax

Practice location:
  • Phone: 419-239-4972
  • Fax:
Mailing address:
  • Phone: 419-239-4972
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberBACB715016
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: