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General NPI Number Information
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NPI Number | 1437878923
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Entity Type | Individual
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Provider Name | DANIELLE NICOLE SAMUELSON LM, CPM
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Gender | Female
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Dates
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Enumeration Date | 08/26/2022
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Last Update Date | 08/26/2022
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Provider Practice Location Address
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Address Line | 3100 SWISS AVE
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City | DALLAS
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State | TX
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Zip | 75204-6025
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Country | US
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Telephone | 469-291-9129
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Fax |
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Provider Business Mailing Address
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Address Line | 3505 SUMMER TRAIL CT
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City | ARLINGTON
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State | TX
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Zip | 76016-3128
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Country | US
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Telephone | 817-584-7533
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Fax |
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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 | 176B00000X
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Taxonomy Name | Midwife
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License Number | 99492
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License Number State | TX
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