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1265917744 NPI number — DANIELLE ASHLEY STAMM LMT, MMP

NPI Number: 1265917744
Health Care Provider/Practitioner: DANIELLE ASHLEY STAMM LMT, MMP

Information about “1265917744” NPI (DANIELLE ASHLEY STAMM LMT, MMP) exists in 1265917744 in HTML format HTML  |  1265917744 in plain Text format TXT  |  1265917744 in PDF (Portable Document Format) PDF  |  1265917744 in an XML format XML  formats.

NPI Number : 1265917744 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265917744",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "STAMM",
    "FirstName": "DANIELLE",
    "MiddleName": "ASHLEY",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMT, MMP",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NELSON",
    "OtherFirstName": "DANIELLE",
    "OtherMiddleName": "ASHLEY",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "LMT, MMP",
    "OtherLastNameTypeCode": "1",
    "FirstLineMailingAddress": "22180 PONTIAC TRAIL",
    "SecondLineMailingAddress": "SUITE E",
    "MailingAddressCityName": "SOUTH LYON",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48178-9097",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "248-446-0155",
    "MailingAddressFaxNumber": "248-446-0177",
    "FirstLinePracticeLocationAddress": "22180 PONTIAC TRAIL",
    "SecondLinePracticeLocationAddress": "SUITE E",
    "PracticeLocationAddressCityName": "SOUTH LYON",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48178-9097",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "248-446-0155",
    "PracticeLocationAddressFaxNumber": "248-446-0177",
    "EnumerationDate": "10/01/2018",
    "LastUpdateDate": "12/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225700000X",
        "TaxonomyName": "Massage Therapist",
        "LicenseNumber": "7501010896",
        "LicenseNumberStateCode": "MI",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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