Provider Demographics
NPI:1154602274
Name:BEAUMONT, DANIELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:DANIELLE
Middle Name:
Last Name:BEAUMONT
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 COMPUTER RD
Mailing Address - Street 2:SUITE J-52
Mailing Address - City:WILLOW GROVE
Mailing Address - State:PA
Mailing Address - Zip Code:19090-1752
Mailing Address - Country:US
Mailing Address - Phone:215-658-4553
Mailing Address - Fax:
Practice Address - Street 1:2300 COMPUTER AVE
Practice Address - Street 2:SUITE J-52
Practice Address - City:WILLOW GROVE
Practice Address - State:PA
Practice Address - Zip Code:19090-1752
Practice Address - Country:US
Practice Address - Phone:215-658-4553
Practice Address - Fax:215-658-1602
Is Sole Proprietor?:No
Enumeration Date:2011-09-02
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS017056103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical