Provider Demographics
NPI:1104612837
Name:DANIELLE PACE PSYD
Entity type:Organization
Organization Name:DANIELLE PACE PSYD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:PACE
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:240-994-7987
Mailing Address - Street 1:90 FAWCETT ST UNIT 204
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-1181
Mailing Address - Country:US
Mailing Address - Phone:240-994-7987
Mailing Address - Fax:
Practice Address - Street 1:90 FAWCETT ST UNIT 204
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-1181
Practice Address - Country:US
Practice Address - Phone:240-994-7987
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center