Healthcare Provider Details

I. General information

NPI: 1285553727
Provider Name (Legal Business Name): DANIELLE T FOSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5350 TRANSPORTATION
GARFIELD HEIGHTS OH
44125-5327
US

IV. Provider business mailing address

4628 HORTON RD
GARFIELD HEIGHTS OH
44125-1253
US

V. Phone/Fax

Practice location:
  • Phone: 216-369-1018
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License NumberPRS.007186
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: