MEDICARE: MS. DANIELLE LYNN SAWYER

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	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1790287662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DANIELLE LYNN SAWYER

Provider Business Mailing Address
First Line	:	716 NICHOLAS PKWY W
Second Line	:
City	:	CAPE CORAL
State	:	FL
Zip	:	33991-2538
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4085 HANCOCK BRIDGE PKWY UNIT 1
Second Line	:
City	:	NORTH FORT MYERS
State	:	FL
Zip	:	33903-7219
Country	:	US
Telephone Number	:	239-677-3767
Fax Number	:

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

Provider Enumeration Date	:	03/06/2018
Last Update Date	:	03/06/2018

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