Healthcare Provider Details

I. General information

NPI: 1851254015
Provider Name (Legal Business Name): DANNIELLE JON CAVE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 12/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3560 MIDLAND DR APT L201
WEST HAVEN UT
84401-9141
US

IV. Provider business mailing address

3560 MIDLAND DR APT L201
WEST HAVEN UT
84401-9141
US

V. Phone/Fax

Practice location:
  • Phone: 208-610-0824
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number14244898-3503
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: