Provider Demographics
NPI:1194054619
Name:TEEL, DANYLL
Entity type:Individual
Prefix:
First Name:DANYLL
Middle Name:
Last Name:TEEL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15505 CIVIC DR
Mailing Address - Street 2:
Mailing Address - City:VICTORVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:92392-2357
Mailing Address - Country:US
Mailing Address - Phone:760-243-8271
Mailing Address - Fax:760-243-8274
Practice Address - Street 1:15505 CIVIC DR
Practice Address - Street 2:
Practice Address - City:VICTORVILLE
Practice Address - State:CA
Practice Address - Zip Code:92392-2357
Practice Address - Country:US
Practice Address - Phone:760-243-8271
Practice Address - Fax:760-243-8274
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-11
Last Update Date:2009-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator