MEDICARE: DANIELLE CORDERMAN BCBA, M.S.

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	103K00000X	Behavior Analyst

General Provider Information

NPI Number	:	1528909470
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE CORDERMAN BCBA, M.S.

Provider Business Mailing Address
First Line	:	5332 W STARGAZER PL
Second Line	:
City	:	LAVEEN
State	:	AZ
Zip	:	85339-4512
Country	:	US
Telephone Number	:	321-652-3871
Fax Number	:

Provider Business Practice Location Address
First Line	:	4530 E RAY RD STE 100
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85044-6095
Country	:	US
Telephone Number	:	602-887-1427
Fax Number	:

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

Provider Enumeration Date	:	04/03/2026
Last Update Date	:	04/03/2026

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