MEDICARE: DANIELLE MARIE NAUGHTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	385HR2060X	Child Intellectual and/or Developmental Disabilities Respite Care

General Provider Information

NPI Number	:	1316181167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MARIE NAUGHTON

Provider Business Mailing Address
First Line	:	1931 S WASHINGTON ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-4855
Country	:	US
Telephone Number	:	307-262-5925
Fax Number	:

Provider Business Practice Location Address
First Line	:	1931 S WASHINGTON ST
Second Line	:
City	:	CASPER
State	:	WY
Zip	:	82601-4855
Country	:	US
Telephone Number	:	307-262-5925
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2009
Last Update Date	:	04/23/2009

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