Healthcare Provider Details

I. General information

NPI: 1083368807
Provider Name (Legal Business Name): DANIELLE GILES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2022
Last Update Date: 08/23/2023
Certification Date: 08/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 S HIGH ST
COLUMBUS OH
43207-4010
US

IV. Provider business mailing address

805 E WASHINGTON ST STE 130
MEDINA OH
44256-3331
US

V. Phone/Fax

Practice location:
  • Phone: 614-365-5229
  • Fax:
Mailing address:
  • Phone: 234-255-8531
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License NumberOT012518
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: