=====================================================
General NPI Number Information
=====================================================
NPI Number | 1013712397
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DANNIELLE KYRILLOS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/19/2025
-----------------------------------------------------
Last Update Date | 02/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 23A HOSPITAL ST. NUMBER 2
-----------------------------------------------------
City | FREDERIKSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00840-1001
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 833-409-3474
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 W VALLEY RD
-----------------------------------------------------
City | CHRISTIANSTED
-----------------------------------------------------
State | VI
-----------------------------------------------------
Zip | 00820-3654
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-447-7230
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 2-67445-2B
-----------------------------------------------------
License Number State | VI
-----------------------------------------------------