Provider Demographics
NPI:1487137857
Name:TANNIAN, DANIELLE (OT)
Entity type:Individual
Prefix:MRS
First Name:DANIELLE
Middle Name:
Last Name:TANNIAN
Suffix:
Gender:F
Credentials:OT
Other - Prefix:MISS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:DUNKLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OT
Mailing Address - Street 1:41 RESNIK RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360-5721
Mailing Address - Country:US
Mailing Address - Phone:781-934-7292
Mailing Address - Fax:508-746-3980
Practice Address - Street 1:41 RESNIK RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-5721
Practice Address - Country:US
Practice Address - Phone:781-934-7292
Practice Address - Fax:508-746-3980
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12883225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist