Healthcare Provider Details

I. General information

NPI: 1093229668
Provider Name (Legal Business Name): DANIELLE M MARSHALL LBS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/19/2017
Last Update Date: 08/15/2025
Certification Date: 08/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 W VINE ST APT A2
STOWE PA
19464-6824
US

IV. Provider business mailing address

11 W VINE ST APT A2
STOWE PA
19464-6824
US

V. Phone/Fax

Practice location:
  • Phone: 610-574-3925
  • Fax:
Mailing address:
  • Phone: 610-574-3925
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106E00000X
TaxonomyAssistant Behavior Analyst
License NumberBH003658
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: