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General NPI Number Information
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NPI Number | 1346053485
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Entity Type | Individual
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Provider Name | DANYELLE BARLOW
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Gender | Female
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Dates
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Enumeration Date | 01/31/2025
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 4450 N PROSPECT RD STE C5
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City | PEORIA HEIGHTS
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State | IL
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Zip | 61616-6578
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Country | US
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Telephone | 309-363-7594
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Fax | 309-966-3621
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Provider Business Mailing Address
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Address Line | 1642 W GENEVA RD
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City | PEORIA
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State | IL
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Zip | 61615-1156
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Country | US
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Telephone | 309-714-1993
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Fax | 309-966-3621
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 150.115908
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License Number State | IL
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