Provider Demographics
NPI:1528827110
Name:MARINO, DANIELLE E (MA, LPAT, ATR-BC)
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:E
Last Name:MARINO
Suffix:
Gender:F
Credentials:MA, LPAT, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 IROQUOIS AVE
Mailing Address - Street 2:
Mailing Address - City:LANDING
Mailing Address - State:NJ
Mailing Address - Zip Code:07850-1307
Mailing Address - Country:US
Mailing Address - Phone:973-570-9229
Mailing Address - Fax:
Practice Address - Street 1:38 IROQUOIS AVE
Practice Address - Street 2:
Practice Address - City:LANDING
Practice Address - State:NJ
Practice Address - Zip Code:07850-1307
Practice Address - Country:US
Practice Address - Phone:973-570-9229
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ16LP00018500221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt TherapistGroup - Single Specialty