Provider Demographics
NPI:1104055615
Name:STANDISH, DANIELLE WRIGHT (PHD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:WRIGHT
Last Name:STANDISH
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1090 N 10TH ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49009-5733
Mailing Address - Country:US
Mailing Address - Phone:269-375-4363
Mailing Address - Fax:
Practice Address - Street 1:1090 N 10TH ST
Practice Address - Street 2:SUITE 110
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49009-5733
Practice Address - Country:US
Practice Address - Phone:269-375-4363
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2009-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301012835103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling