Healthcare Provider Details

I. General information

NPI: 1639074750
Provider Name (Legal Business Name): DANIELLE TOVAR M.S. LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLE CHO-XAYAMOUNGKHOUN

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date: 10/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N 52ND ST APT 2
PHILADELPHIA PA
19131-5105
US

IV. Provider business mailing address

631 N 52ND ST APT 2
PHILADELPHIA PA
19131-5105
US

V. Phone/Fax

Practice location:
  • Phone: 267-361-9313
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBH008333
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: