Provider Demographics
NPI:1427837038
Name:DANIELE, SAVANNAH LEE (CASE MANAGER)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:LEE
Last Name:DANIELE
Suffix:
Gender:F
Credentials:CASE MANAGER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:188 W HEBBLE AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4960
Mailing Address - Country:US
Mailing Address - Phone:614-314-4172
Mailing Address - Fax:
Practice Address - Street 1:5439 BURKHARDT RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45431-2111
Practice Address - Country:US
Practice Address - Phone:937-791-1440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-22
Last Update Date:2023-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator