MEDICARE: DANIELLE TERRITO

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	103TS0200X	School Psychologist

General Provider Information

NPI Number	:	1902680408
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE TERRITO

Provider Business Mailing Address
First Line	:	2950 BELFRY LN APT 201
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-2599
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2950 BELFRY LN APT 201
Second Line	:
City	:	WEST LAFAYETTE
State	:	IN
Zip	:	47906-2599
Country	:	US
Telephone Number	:	908-565-2935
Fax Number	:

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

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	08/24/2023

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Directions to “ DANIELLE TERRITO ” Practice Location

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