Healthcare Provider Details

I. General information

NPI: 1194986844
Provider Name (Legal Business Name): DANIELLE LINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DANIELLE EARLS

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 09/29/2023
Certification Date: 09/29/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E WASHINGTON ST SUITE 150
MEDINA OH
44256-3335
US

IV. Provider business mailing address

7716 ELYRIA RD
MEDINA OH
44256-9480
US

V. Phone/Fax

Practice location:
  • Phone: 330-722-1069
  • Fax: 330-764-9712
Mailing address:
  • Phone: 330-591-5448
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code172A00000X
TaxonomyDriver
License NumberSH109874
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: