Provider Demographics
NPI:1124426390
Name:ENDEJAN, DANIELLE ELIZABETH (MA PLPC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:ELIZABETH
Last Name:ENDEJAN
Suffix:
Gender:F
Credentials:MA PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9890 CLAYTON RD
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63124-1685
Mailing Address - Country:US
Mailing Address - Phone:314-222-5888
Mailing Address - Fax:314-222-5889
Practice Address - Street 1:9890 CLAYTON RD
Practice Address - Street 2:SUITE 115
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63124-1685
Practice Address - Country:US
Practice Address - Phone:314-222-5888
Practice Address - Fax:314-222-5889
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009004733101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor