Healthcare Provider Details

I. General information

NPI: 1649978750
Provider Name (Legal Business Name): DR. DANIELLE MARIE LAUTZENHEISER PH.D. H.I.C.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/17/2023
Last Update Date: 02/17/2023
Certification Date: 02/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8017 CRANES CROSSING DR
LEWIS CENTER OH
43035-8633
US

IV. Provider business mailing address

3981 EDGEWATER CT STE J
LEWIS CENTER OH
43035-7174
US

V. Phone/Fax

Practice location:
  • Phone: 614-625-5911
  • Fax:
Mailing address:
  • Phone: 614-625-5911
  • Fax: 614-543-1425

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code173C00000X
TaxonomyReflexologist
License Number
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: