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General NPI Number Information
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NPI Number | 1508240128
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Entity Type | Individual
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Provider Name | DANIELLE DILLARD
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Gender | Female
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Dates
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Enumeration Date | 07/14/2015
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Last Update Date | 05/28/2020
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Provider Practice Location Address
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Address Line | 3851 COMMERCIAL CENTER DR
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City | LADSON
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State | SC
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Zip | 29456-4146
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Country | US
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Telephone | 843-314-5434
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Fax |
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Provider Business Mailing Address
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Address Line | 8627 SCENIC VIEW DR APT 2207
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City | FORT WORTH
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State | TX
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Zip | 76244-9272
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Country | US
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Telephone | 828-455-6782
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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 | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 117043
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 5843
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License Number State | SC
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